Provider Demographics
NPI:1720317712
Name:MCGINNIS, WANDA KAY (MA,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:WANDA
Middle Name:KAY
Last Name:MCGINNIS
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Gender:F
Credentials:MA,CCC-SLP
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Mailing Address - Street 1:12200 FAIRHILL RD
Mailing Address - Street 2:SUITE C248
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1058
Mailing Address - Country:US
Mailing Address - Phone:216-791-7334
Mailing Address - Fax:855-744-0350
Practice Address - Street 1:12200 FAIRHILL RD
Practice Address - Street 2:SUITE C248
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1058
Practice Address - Country:US
Practice Address - Phone:216-791-7334
Practice Address - Fax:855-744-0350
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-22
Last Update Date:2016-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH3667235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist