Provider Demographics
NPI:1699970038
Name:DUARTE-MCCASKILL, GLORIA (MCD,CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:
Last Name:DUARTE-MCCASKILL
Suffix:
Gender:F
Credentials:MCD,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:PO BOX 241975
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28224-1975
Mailing Address - Country:US
Mailing Address - Phone:704-458-3817
Mailing Address - Fax:704-504-0828
Practice Address - Street 1:2004 LILLY POND CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-3806
Practice Address - Country:US
Practice Address - Phone:704-458-3817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-16
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5677235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist