Provider Demographics
NPI:1750613352
Name:COREY, KATHRYN E (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:COREY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 J T HEATH RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-8705
Mailing Address - Country:US
Mailing Address - Phone:252-809-2826
Mailing Address - Fax:
Practice Address - Street 1:1414 J T HEATH RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-8705
Practice Address - Country:US
Practice Address - Phone:252-809-2826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5514235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist