Provider Demographics
NPI:1629466529
Name:MCINNES, DARCI (SLPA)
Entity Type:Individual
Prefix:
First Name:DARCI
Middle Name:
Last Name:MCINNES
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:DARCI
Other - Middle Name:
Other - Last Name:WILKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:480 N BISBEE AVE
Mailing Address - Street 2:
Mailing Address - City:WILLCOX
Mailing Address - State:AZ
Mailing Address - Zip Code:85643-1509
Mailing Address - Country:US
Mailing Address - Phone:520-384-8608
Mailing Address - Fax:
Practice Address - Street 1:480 N BISBEE AVE
Practice Address - Street 2:
Practice Address - City:WILLCOX
Practice Address - State:AZ
Practice Address - Zip Code:85643-1509
Practice Address - Country:US
Practice Address - Phone:520-384-8608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA 89752355S0801X
AZSLPA89752355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant