Provider Demographics
NPI:1215153598
Name:MCCLAIN, AMY WHITE (MCD, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:WHITE
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 CALAIS DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4202
Mailing Address - Country:US
Mailing Address - Phone:843-270-8697
Mailing Address - Fax:
Practice Address - Street 1:1218 CALAIS DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4202
Practice Address - Country:US
Practice Address - Phone:843-270-8697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3632235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist