Provider Demographics
NPI:1013480722
Name:MCGRATH, SCOTT DANIEL (AUD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:DANIEL
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 E SOUTHERN AVE STE 20
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7667
Mailing Address - Country:US
Mailing Address - Phone:480-833-4330
Mailing Address - Fax:480-833-1902
Practice Address - Street 1:2501 E SOUTHERN AVE STE 20
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7667
Practice Address - Country:US
Practice Address - Phone:480-833-4330
Practice Address - Fax:480-833-1902
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDA11567OtherSTATE LICENSE NUMBER