Provider Demographics
NPI:1871730630
Name:MCCORRY, SAMANTHA K (MA CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:K
Last Name:MCCORRY
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4126
Mailing Address - Country:US
Mailing Address - Phone:412-736-0581
Mailing Address - Fax:
Practice Address - Street 1:505 WEYMAN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-1584
Practice Address - Country:US
Practice Address - Phone:412-884-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007573235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist