Doctor Name: | MRS. CHARITY RENEE MACKLEY |
NPI Number: | 1710139134 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCC-SLP |
License Number: | 2008021060 |
Business Practice Address: | 700 Park Dr Ironton, MO - 636501480 |
Business Phone Number: | 5735469700 |
Business Fax Number: | |
Mailing Address: | 3833 Highway O, FARMINGTON |
State: | MO |
Postal Code: | 636407221 |
Phone Number: | 5734315596 |
Fax Number: | 5734315596 |
NPI Enumeration Date: | 10/16/2008 |
NPI Last Update Date: | 10/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2008021060 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
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 |