Basic Information
| Provider Information | |||||||||
| NPI: | 1851913131 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCALES | ||||||||
| FirstName: | AUTUMN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2164 | ||||||||
| Address2: | |||||||||
| City: | SOUTHERN PINES | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283882164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9105089045 | ||||||||
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| Practice Location | |||||||||
| Address1: | 40 DUKE MEDICINE CIR | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277104000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196846271 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2020 | ||||||||
| LastUpdateDate: | 05/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.