Provider Demographics
NPI:1912473794
Name:MCCAY PEDIATRIC SPEECH & LANGUAGE SERVICES PLLC
Entity Type:Organization
Organization Name:MCCAY PEDIATRIC SPEECH & LANGUAGE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGED SPEECH LANGUAGE PATH
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCCAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA/CCC-SLP
Authorized Official - Phone:703-819-0310
Mailing Address - Street 1:200 ELLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5012
Mailing Address - Country:US
Mailing Address - Phone:703-819-0310
Mailing Address - Fax:910-425-1116
Practice Address - Street 1:200 ELLINGTON ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5012
Practice Address - Country:US
Practice Address - Phone:703-819-0310
Practice Address - Fax:910-425-1116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty