Provider Demographics
NPI:1740501360
Name:MCSURDY, KATHRYN L (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:L
Last Name:MCSURDY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1360 MAIN ST
Mailing Address - Street 2:UNIT 201
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-2197
Mailing Address - Country:US
Mailing Address - Phone:978-618-8404
Mailing Address - Fax:
Practice Address - Street 1:365 EAST ST
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1950
Practice Address - Country:US
Practice Address - Phone:978-851-7321
Practice Address - Fax:978-863-2235
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist