Provider Demographics
NPI:1174778948
Name:MCGEEHAN, ROBIN (MA CCC/SLP/L)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:MCGEEHAN
Suffix:
Gender:F
Credentials:MA CCC/SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 BEAR CREEK LAKE DR
Mailing Address - Street 2:
Mailing Address - City:JIM THORPE
Mailing Address - State:PA
Mailing Address - Zip Code:18229-2819
Mailing Address - Country:US
Mailing Address - Phone:570-510-7095
Mailing Address - Fax:
Practice Address - Street 1:397 BEAR CREEK LAKE DR
Practice Address - Street 2:
Practice Address - City:JIM THORPE
Practice Address - State:PA
Practice Address - Zip Code:18229-2819
Practice Address - Country:US
Practice Address - Phone:570-510-7095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL003126L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist