Provider Demographics
NPI:1417097726
Name:MCELHINNEY, GWYNNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:PROF
First Name:GWYNNE
Middle Name:
Last Name:MCELHINNEY
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 1:3612 GREENBRIER DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-4515
Mailing Address - Country:US
Mailing Address - Phone:208-342-0102
Mailing Address - Fax:
Practice Address - Street 1:12301 W EXPLORER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-1571
Practice Address - Country:US
Practice Address - Phone:208-373-1724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-1222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist