Provider Demographics
NPI:1861696767
Name:IRWIN, CATHERINE ANN (MS, SLP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:IRWIN
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 S. GALVESTON AVE
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-4536
Mailing Address - Country:US
Mailing Address - Phone:479-967-0228
Mailing Address - Fax:479-967-0228
Practice Address - Street 1:3001 SPRING FOREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2817
Practice Address - Country:US
Practice Address - Phone:919-424-5080
Practice Address - Fax:919-424-5080
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3840235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist