Provider Demographics
NPI:1871578179
Name:MACGREGOR, KATE SULLIVAN (SLP)
Entity type:Individual
Prefix:MRS
First Name:KATE
Middle Name:SULLIVAN
Last Name:MACGREGOR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 HAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4509
Mailing Address - Country:US
Mailing Address - Phone:803-980-4900
Mailing Address - Fax:803-980-4902
Practice Address - Street 1:129 HAMPTON ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4509
Practice Address - Country:US
Practice Address - Phone:803-980-4900
Practice Address - Fax:803-980-4902
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3399235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA0683Medicaid