Provider Demographics
NPI:1336389766
Name:MCCREADY, PAULETTE CAMILLE (CCC-SLP/TSHH)
Entity Type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:CAMILLE
Last Name:MCCREADY
Suffix:
Gender:F
Credentials:CCC-SLP/TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 FREDERICK LN
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6505
Mailing Address - Country:US
Mailing Address - Phone:917-371-8186
Mailing Address - Fax:
Practice Address - Street 1:53 FREDERICK LN
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6505
Practice Address - Country:US
Practice Address - Phone:917-371-8186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010426-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist