Provider Demographics
NPI:1023267481
Name:MCDOUGALD, BRAE LIN (MA, CCC-A)
Entity type:Individual
Prefix:MS
First Name:BRAE
Middle Name:LIN
Last Name:MCDOUGALD
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15207 DUNCAN GROVE DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4918
Mailing Address - Country:US
Mailing Address - Phone:512-567-9306
Mailing Address - Fax:
Practice Address - Street 1:5705 4TH ST UNIT 2
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2432
Practice Address - Country:US
Practice Address - Phone:281-838-5442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60481231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist