Provider Demographics
NPI:1750410106
Name:MCKENNEY, NEYSA PATRICIA (SLP)
Entity type:Individual
Prefix:MRS
First Name:NEYSA
Middle Name:PATRICIA
Last Name:MCKENNEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24289 AMBOUR DR
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-1346
Mailing Address - Country:US
Mailing Address - Phone:216-344-1723
Mailing Address - Fax:440-356-5323
Practice Address - Street 1:1101 MOREWOOD PKWY
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-1439
Practice Address - Country:US
Practice Address - Phone:440-356-5321
Practice Address - Fax:440-356-5323
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP2766235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist