Provider Demographics
NPI:1982968855
Name:MCPIKE, PATRICIA (SLP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MCPIKE
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 1:193 SUNSET LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-9744
Mailing Address - Country:US
Mailing Address - Phone:802-257-4759
Mailing Address - Fax:
Practice Address - Street 1:193 SUNSET LAKE RD
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-9744
Practice Address - Country:US
Practice Address - Phone:802-257-4759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist