Provider Demographics
NPI:1710968854
Name:SCALORA, KATHARINE HAWKES (SLP MS CCCSLP)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:HAWKES
Last Name:SCALORA
Suffix:
Gender:F
Credentials:SLP MS CCCSLP
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:
Other - Last Name:HAWKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:84 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155
Mailing Address - Country:US
Mailing Address - Phone:781-391-0303
Mailing Address - Fax:781-391-9922
Practice Address - Street 1:84 HIGH STREET
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155
Practice Address - Country:US
Practice Address - Phone:781-391-0303
Practice Address - Fax:781-391-9922
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5830235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA226525Medicare ID - Type Unspecified