MEDICARE: CATHERINE ROSE KUCZKOWSKI MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	210323	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710577572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE ROSE KUCZKOWSKI MS, CCC-SLP

Provider Business Mailing Address
First Line	:	9728 DANSINGTON CT
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-4138
Country	:	US
Telephone Number	:	336-430-8096
Fax Number	:

Provider Business Practice Location Address
First Line	:	8390 SIX FORKS RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-3060
Country	:	US
Telephone Number	:	919-987-5833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2021
Last Update Date	:	03/12/2024

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Directions to “ CATHERINE ROSE KUCZKOWSKI MS, CCC-SLP” Practice Location

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