Basic Information
| Provider Information | |||||||||
| NPI: | 1013197508 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WAUGH | ||||||||
| FirstName: | KATY | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | DIVISION OF SPEECH PATHOLOGY & AUDIOLOGY | ||||||||
| Address2: | 155 BAKER HOUSE, TRENT DR. | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277100001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196684295 | ||||||||
| FaxNumber: | 9196682741 | ||||||||
| Practice Location | |||||||||
| Address1: | DIVISION OF SPEECH PATHOLOGY & AUDIOLOGY | ||||||||
| Address2: | 155 BAKER HOUSE, TRENT DR. | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277100001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196684295 | ||||||||
| FaxNumber: | 9196682741 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2007 | ||||||||
| LastUpdateDate: | 11/13/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 7637 | NC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.