Provider Demographics
NPI:1487971388
Name:MCKENNA, NOEL ELIZABETH (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:NOEL
Middle Name:ELIZABETH
Last Name:MCKENNA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 NOB CIR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1247
Mailing Address - Country:US
Mailing Address - Phone:845-702-7984
Mailing Address - Fax:
Practice Address - Street 1:34 NOB CIR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1247
Practice Address - Country:US
Practice Address - Phone:845-702-7984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-01
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019739-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist