MEDICARE: KAYLEE SHEA MCGEARY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		PA

General Provider Information

NPI Number	:	1407462708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE SHEA MCGEARY

Provider Business Mailing Address
First Line	:	2851 FALLS RD
Second Line	:
City	:	FALLS
State	:	PA
Zip	:	18615-7732
Country	:	US
Telephone Number	:	570-290-1398
Fax Number	:

Provider Business Practice Location Address
First Line	:	1081 OAK ST STE 3
Second Line	:
City	:	INKERMAN
State	:	PA
Zip	:	18640-3716
Country	:	US
Telephone Number	:	570-802-3099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	09/22/2020

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Directions to “ KAYLEE SHEA MCGEARY ” Practice Location

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