Provider Demographics
NPI:1326166992
Name:MCKEEVER, AMY LYNN (MSCFY-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:MCKEEVER
Suffix:
Gender:F
Credentials:MSCFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 S TYLER ST APT 1
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-2670
Mailing Address - Country:US
Mailing Address - Phone:806-676-3708
Mailing Address - Fax:
Practice Address - Street 1:5500 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4100
Practice Address - Country:US
Practice Address - Phone:806-468-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102933235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist