Provider Demographics
NPI:1942194352
Name:SHOULTS, KADY (AUD)
Entity type:Individual
Prefix:
First Name:KADY
Middle Name:
Last Name:SHOULTS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KADYN
Other - Middle Name:
Other - Last Name:SHOULTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:121 PEGASUS ST APT H-10
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-5075
Mailing Address - Country:US
Mailing Address - Phone:304-691-9707
Mailing Address - Fax:304-691-9707
Practice Address - Street 1:44 ELM ST
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1418
Practice Address - Country:US
Practice Address - Phone:207-449-3809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP4384231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist