Provider Demographics
NPI:1922501907
Name:MCCOY, PATRICIA FAYE
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:FAYE
Last Name:MCCOY
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 1:130 LOWER SALTWELL RD
Mailing Address - Street 2:
Mailing Address - City:INEZ
Mailing Address - State:KY
Mailing Address - Zip Code:41224-8992
Mailing Address - Country:US
Mailing Address - Phone:606-369-4219
Mailing Address - Fax:
Practice Address - Street 1:130 LOWER SALTWELL RD
Practice Address - Street 2:
Practice Address - City:INEZ
Practice Address - State:KY
Practice Address - Zip Code:41224-8992
Practice Address - Country:US
Practice Address - Phone:606-369-4219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist