MEDICARE: MRS. MARY ELLEN MCGEEHAN

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	235Z00000X	Speech-Language Pathologist	1527	KS

General Provider Information

NPI Number	:	1639391360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY ELLEN MCGEEHAN

Provider Business Mailing Address
First Line	:	10024 JUNIPER LN
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66207-3447
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10024 JUNIPER LN
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66207-3447
Country	:	US
Telephone Number	:	913-638-8829
Fax Number	:

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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