Provider Demographics
NPI:1215399555
Name:MCGEE, JAYNE
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:
Last Name:MCGEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26770 E CARNEGIE PARK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-6154
Mailing Address - Country:US
Mailing Address - Phone:313-575-1712
Mailing Address - Fax:
Practice Address - Street 1:26770 E CARNEGIE PARK DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-6154
Practice Address - Country:US
Practice Address - Phone:313-575-1712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101000008235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist