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General NPI Number Information
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NPI Number | 1275983504
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Entity Type | Individual
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Provider Name | KORRINE BETHANY MCGOUGH M.S. ED., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | HARMONY HILL ELEMENTARY SCHOOL 120 MADELINE HICKEY WAY
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City | COHOES
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State | NY
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Zip | 12047
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Country | US
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Telephone | 518-233-1900
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Fax | 518-237-1964
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Provider Business Mailing Address
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Address Line | COHOES CITY SCHOOL DISTRICT: OFFICE OF SPECIAL PROGRAMS 21 PAGE AVENUE
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City | COHOES
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State | NY
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Zip | 12047
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Country | US
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Telephone | 518-237-0100
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Fax | 518-237-2912
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 026807
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License Number State | NY
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