Provider Demographics
NPI:1396916813
Name:MCKEE- ANDERSON, WENDY LEE (CCSLP-MS)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LEE
Last Name:MCKEE- ANDERSON
Suffix:
Gender:F
Credentials:CCSLP-MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 71 BOX 192 AA
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:WV
Mailing Address - Zip Code:26704
Mailing Address - Country:US
Mailing Address - Phone:304-496-8447
Mailing Address - Fax:
Practice Address - Street 1:111 SCHOOL STREET
Practice Address - Street 2:HAMPSHIRE COUNTY BOARD OF EDUCATION
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757
Practice Address - Country:US
Practice Address - Phone:304-822-3258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1837235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0155430000Medicaid