Provider Demographics
NPI:1306097787
Name:MCGAHA, TANIA LOU (MCD)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:LOU
Last Name:MCGAHA
Suffix:
Gender:F
Credentials:MCD
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:LOU
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCD
Mailing Address - Street 1:1223 COUNTY ROAD 476
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-8203
Mailing Address - Country:US
Mailing Address - Phone:870-938-1011
Mailing Address - Fax:
Practice Address - Street 1:1223 COUNTY ROAD 476
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-8203
Practice Address - Country:US
Practice Address - Phone:870-938-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1025235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty