Provider Demographics
NPI:1295067098
Name:MCELPRANG, MAKIEA SUSANNE (BS)
Entity type:Individual
Prefix:
First Name:MAKIEA
Middle Name:SUSANNE
Last Name:MCELPRANG
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1757 E GARY ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-4508
Mailing Address - Country:US
Mailing Address - Phone:480-329-1960
Mailing Address - Fax:
Practice Address - Street 1:32 SPUR CIR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5461
Practice Address - Country:US
Practice Address - Phone:480-219-6566
Practice Address - Fax:480-656-3948
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA65322355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant