Provider Demographics
NPI:1891251674
Name:MCKAIG, RILIE ANN
Entity Type:Individual
Prefix:
First Name:RILIE
Middle Name:ANN
Last Name:MCKAIG
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 1:3111 JORCLAY DR
Mailing Address - Street 2:
Mailing Address - City:KENOVA
Mailing Address - State:WV
Mailing Address - Zip Code:25530-9533
Mailing Address - Country:US
Mailing Address - Phone:937-361-3670
Mailing Address - Fax:
Practice Address - Street 1:1113 EAGLE CROSSING CT
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-9799
Practice Address - Country:US
Practice Address - Phone:937-361-3670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-16
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY244387235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist