Provider Demographics
NPI:1932390648
Name:MCKEE, KRISTIN LEIGH (SP)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:LEIGH
Last Name:MCKEE
Suffix:
Gender:F
Credentials:SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:28401 LOS ALISOS BLVD
Mailing Address - Street 2:#6304
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-5951
Mailing Address - Country:US
Mailing Address - Phone:949-581-8239
Mailing Address - Fax:949-859-0849
Practice Address - Street 1:23361 MADERO
Practice Address - Street 2:SUITE 200
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2715
Practice Address - Country:US
Practice Address - Phone:949-599-0218
Practice Address - Fax:949-859-0928
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSP16275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist