Individual
SUSANNA C MCKINLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1333 WELLS ST, NILES, MI 49120-1543
(269) 684-1111
Mailing address
53211 TOWHEE LN, SOUTH BEND, IN 46637-5155
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22001577A
IN
235Z00000X
Speech-Language Pathologist
Primary
7101005376
MI
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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