Provider Demographics
NPI:1700664208
Name:LIVENGOOD, CATHY LEE (BC-HIS)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:LEE
Last Name:LIVENGOOD
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5041 EXECUTIVE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2507
Mailing Address - Country:US
Mailing Address - Phone:252-773-0636
Mailing Address - Fax:877-771-3406
Practice Address - Street 1:7100 SIX FORKS RD STE 120
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6260
Practice Address - Country:US
Practice Address - Phone:919-727-8008
Practice Address - Fax:877-771-3406
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1664237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist