Provider Demographics
NPI:1962996199
Name:MCINNIS, DARCY ANN (MS, SLP-CCC)
Entity type:Individual
Prefix:
First Name:DARCY
Middle Name:ANN
Last Name:MCINNIS
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1164 HIGH SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410-5175
Mailing Address - Country:US
Mailing Address - Phone:702-595-6897
Mailing Address - Fax:
Practice Address - Street 1:1164 HIGH SCHOOL ST
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5175
Practice Address - Country:US
Practice Address - Phone:702-595-6897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1672235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist