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General NPI Number Information
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NPI Number | 1295675734
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Entity Type | Organization
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Legal Business Name | THE FUNCTIONAL SLP PLLC
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Dates
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Enumeration Date | 04/01/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 8090 SOUTH DURANGO DRIVE 5067 SUITE 102
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City | LAS VEGAS
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State | NV
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Zip | 89113
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Country | US
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Telephone | 725-232-6483
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Fax |
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Provider Business Mailing Address
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Address Line | 7880 W MAULE AVE UNIT 1343
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City | LAS VEGAS
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State | NV
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Zip | 89113-5390
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MAKAYLA JONES-MCCUNE
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Credential | M.S.,CCC-SLP
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Telephone | 725-232-6483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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