Provider Demographics
NPI:1780824813
Name:MCKAY GEHAN, AMY K (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:MCKAY GEHAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 W PARKER RD # 278-196
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7767
Mailing Address - Country:US
Mailing Address - Phone:972-608-0416
Mailing Address - Fax:972-608-0430
Practice Address - Street 1:5928 W PARKER RD STE 1000
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6435
Practice Address - Country:US
Practice Address - Phone:972-608-0416
Practice Address - Fax:972-608-0430
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18057235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F22522Medicare PIN