Provider Demographics
NPI:1487702163
Name:MCCAULEY, LINDA GAYLE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:GAYLE
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 33RD ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-1743
Mailing Address - Country:US
Mailing Address - Phone:304-428-6198
Mailing Address - Fax:
Practice Address - Street 1:2014 DUDLEY AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3405
Practice Address - Country:US
Practice Address - Phone:304-420-5783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0179235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist