Provider Demographics
NPI:1750014551
Name:MCCAULEY, DEVONNA DAISY (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DEVONNA
Middle Name:DAISY
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8563 UPTON CIR UNIT 308
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4057
Mailing Address - Country:US
Mailing Address - Phone:443-442-7556
Mailing Address - Fax:
Practice Address - Street 1:7723 JASPER AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-7719
Practice Address - Country:US
Practice Address - Phone:904-725-8044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA20375235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist