Provider Demographics
NPI:1114171709
Name:MCCLAIN, PATRICIA MARGARET (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MARGARET
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:COPAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12516-1026
Mailing Address - Country:US
Mailing Address - Phone:518-329-1173
Mailing Address - Fax:
Practice Address - Street 1:1265 LAKEVIEW RD
Practice Address - Street 2:
Practice Address - City:COPAKE
Practice Address - State:NY
Practice Address - Zip Code:12516-1026
Practice Address - Country:US
Practice Address - Phone:518-329-1173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-09
Last Update Date:2008-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012984-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist