Provider Demographics
NPI:1831751304
Name:MCKEE, MIRANDA (SLP)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:MCKEE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:ELIZABETH
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:85 N MEDICAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-1907
Mailing Address - Country:US
Mailing Address - Phone:801-587-3422
Mailing Address - Fax:
Practice Address - Street 1:85 N MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-1100
Practice Address - Country:US
Practice Address - Phone:801-581-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT113528264104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist