MEDICARE: CATHERINE MEDD-DUDLEY

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	11210	NC

General Provider Information

NPI Number	:	1649638149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE MEDD-DUDLEY

Provider Business Mailing Address
First Line	:	2010 FAIRCHELSEA WAY LN
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-8801
Country	:	US
Telephone Number	:	919-357-3887
Fax Number	:

Provider Business Practice Location Address
First Line	:	4032 BANNOCKBURN PL APT A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-4549
Country	:	US
Telephone Number	:	919-357-3887
Fax Number	:

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

Provider Enumeration Date	:	01/29/2016
Last Update Date	:	03/24/2022

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Directions to “ CATHERINE MEDD-DUDLEY ” Practice Location

Language	Start Address	Practice Location

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