Doctor Name: | MRS. MINDI MICHELLE MCKINNEY |
NPI Number: | 1205956281 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.CCC-SLP |
License Number: | 22003202A |
Business Practice Address: | 3162 E State Route 62 Boonville, IN - 476019118 |
Business Phone Number: | 8128971061 |
Business Fax Number: | 8128971061 |
Mailing Address: | 3162 E State Route 62, BOONVILLE |
State: | IN |
Postal Code: | 476019118 |
Phone Number: | 8128971061 |
Fax Number: | 8128971061 |
NPI Enumeration Date: | 03/31/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22003202A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |