Provider Demographics
NPI:1760723639
Name:MCCARY, JENNIFER DENISE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DENISE
Last Name:MCCARY
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 1:700 COUNTY ROAD 342
Mailing Address - Street 2:
Mailing Address - City:MILANO
Mailing Address - State:TX
Mailing Address - Zip Code:76556-2606
Mailing Address - Country:US
Mailing Address - Phone:979-450-4255
Mailing Address - Fax:
Practice Address - Street 1:1010 W JASPER DR
Practice Address - Street 2:SUITE 9
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-1331
Practice Address - Country:US
Practice Address - Phone:254-781-7397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-02
Last Update Date:2013-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107741235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist