| Doctor Name: | MRS. TAMMY SUE MCKISSICK |
| NPI Number: | 1841207990 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. CCC/SLP |
| License Number: | SL007466 |
| Business Practice Address: | 1700 S Lincoln Ave Lebanon, PA - 170427529 |
| Business Phone Number: | 7172726621 |
| Business Fax Number: | |
| Mailing Address: | 18 Mayflower Dr, JONESTOWN |
| State: | PA |
| Postal Code: | 170389424 |
| Phone Number: | 7178653158 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SL007466 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| 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 |