Provider Demographics
NPI:1770990087
Name:MCGAHA, JEANNIE L (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:JEANNIE
Middle Name:L
Last Name:MCGAHA
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 1:2441 S HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-2935
Mailing Address - Country:US
Mailing Address - Phone:606-677-4068
Mailing Address - Fax:606-677-4165
Practice Address - Street 1:2441 S HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-2935
Practice Address - Country:US
Practice Address - Phone:606-677-4068
Practice Address - Fax:606-677-4165
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1615235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist