MEDICARE: CONNOR CAROLINE DAUGHTRIDGE

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	30001667	NC

General Provider Information

NPI Number	:	1447199443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNOR CAROLINE DAUGHTRIDGE

Provider Business Mailing Address
First Line	:	4909 WATERS EDGE DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27606-0039
Country	:	US
Telephone Number	:	919-285-1647
Fax Number	:

Provider Business Practice Location Address
First Line	:	4909 WATERS EDGE DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27606-0039
Country	:	US
Telephone Number	:	919-285-1647
Fax Number	:

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

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	04/08/2026

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Directions to “ CONNOR CAROLINE DAUGHTRIDGE ” Practice Location

Language	Start Address	Practice Location

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