| Doctor Name: | MR. CLIFFORD MCKENNON |
| NPI Number: | 1285787432 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | SLPA |
| License Number: | 33902 |
| Business Practice Address: | 1052 E Washington St Stephenville, TX - 764014558 |
| Business Phone Number: | 2549653611 |
| Business Fax Number: | 2549653618 |
| Mailing Address: | 5909 N Highway 281, MINERAL WELLS |
| State: | TX |
| Postal Code: | 760672509 |
| Phone Number: | 9403251072 |
| Fax Number: | 2549653611 |
| NPI Enumeration Date: | 01/19/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | 33902 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |