Provider Demographics
NPI:1821523895
Name:MCCUE, CASSIDY SHAY
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:SHAY
Last Name:MCCUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E HURON ST
Mailing Address - Street 2:APT 2709
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2766
Mailing Address - Country:US
Mailing Address - Phone:630-908-0298
Mailing Address - Fax:
Practice Address - Street 1:30 E HURON ST
Practice Address - Street 2:APT 2709
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2766
Practice Address - Country:US
Practice Address - Phone:630-908-0298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist