Provider Demographics
NPI:1831919836
Name:MCDADE, MARY MARGARET (MS SPEECH PATHOLOGY)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:MCDADE
Suffix:
Gender:F
Credentials:MS SPEECH PATHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 ORLANDO WAY APT B
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4588
Mailing Address - Country:US
Mailing Address - Phone:252-714-4366
Mailing Address - Fax:
Practice Address - Street 1:208 ORLANDO WAY APT B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4588
Practice Address - Country:US
Practice Address - Phone:252-714-4366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist