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General NPI Number Information
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NPI Number | 1891474631
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Entity Type | Individual
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Provider Name | STEPHANIE MCKEEHAN MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 1207 E MAIN ST
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City | SANTA MARIA
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State | CA
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Zip | 93454-4701
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Country | US
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Telephone | 805-739-3185
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Fax |
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Provider Business Mailing Address
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Address Line | 843 SUNSHINE CT
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City | SANTA MARIA
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State | CA
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Zip | 93455-2170
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Country | US
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Telephone | 805-720-2236
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 33284
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License Number State | CA
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