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NPI Code Detail

MEDICARE: CHERYL MCCLURE MCDOUGAL M.A., CCC-SLP

MEDICARE: CHERYL MCCLURE MCDOUGAL M.A., 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
1235Z00000XSpeech-Language Pathologist834NC

Other Identifiers

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

General Provider Information

NPI Number : 1124163241
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL MCCLURE MCDOUGAL M.A., CCC-SLP
Provider Business Mailing Address
First Line : 4013 SKIPJACK CT
Second Line :
City : RALEIGH
State : NC
Zip : 27613-1568
Country : US
Telephone Number : 919-783-7476
Fax Number :
Provider Business Practice Location Address
First Line : 314 CHAPANOKE RD
Second Line :
City : RALEIGH
State : NC
Zip : 27603-3400
Country : US
Telephone Number : 919-773-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/08/2007

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