Provider Demographics
NPI:1497088843
Name:MCHALE, EILEEN R (MS CCC-SLP-L)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:R
Last Name:MCHALE
Suffix:
Gender:F
Credentials:MS CCC-SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 SOUTH HOOPES AVENUE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-4262
Mailing Address - Country:US
Mailing Address - Phone:315-730-8422
Mailing Address - Fax:
Practice Address - Street 1:301 VALLEY DRIVE
Practice Address - Street 2:PARKSIDE CHILDREN'S CENTER
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13207
Practice Address - Country:US
Practice Address - Phone:315-468-1632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016653235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist