Provider Demographics
NPI:1245708213
Name:COX, CATHERINE H (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:H
Last Name:COX
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 NESSEE ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-8483
Mailing Address - Country:US
Mailing Address - Phone:910-574-6017
Mailing Address - Fax:
Practice Address - Street 1:SOUTHEASTERN COMMUNICATION AND SWALLOWING SPECIALISTS
Practice Address - Street 2:3530 BOONE TRAIL
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306
Practice Address - Country:US
Practice Address - Phone:910-439-6545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12985235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA$$$$$$$$$Medicaid