Individual
MRS. ELIZABETH MIKELL MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC/SLP
Contact information
Practice address
7370 CABOT CT, MELBOURNE, FL 32940-8263
(321) 622-8792
Mailing address
6445 GENOA TRL, MELBOURNE, FL 32940-7400
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA10216
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12096450
AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION
—
01
—
SA10216
FL DOH
FL
Enumeration date
08/28/2018
Last updated
08/28/2018
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