Individual
MCKENZIE ELAINE CASSIDY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.-CCC-SLP
Contact information
Practice address
411 E CHESTNUT ST # 2, LOUISVILLE, KY 40202-1713
(502) 588-0850
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300046593
—
IN
05
—
7100551330
—
KY
Enumeration date
05/15/2018
Last updated
03/13/2023
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