Provider Demographics
NPI:1235446030
Name:MCDERMOTT, ELAINE
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:MCDERMOTT
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 1:1215 E TRUMAN RD
Mailing Address - Street 2:ROOM:349
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-3152
Mailing Address - Country:US
Mailing Address - Phone:816-418-5204
Mailing Address - Fax:816-418-5230
Practice Address - Street 1:1215 E TRUMAN RD
Practice Address - Street 2:ROOM:349
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-3152
Practice Address - Country:US
Practice Address - Phone:816-418-5204
Practice Address - Fax:816-418-5230
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist