Provider Demographics
NPI:1144360827
Name:MCGINLEY, SANDRA J (MS, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:J
Last Name:MCGINLEY
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 LOWS RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-8708
Mailing Address - Country:US
Mailing Address - Phone:570-387-4368
Mailing Address - Fax:570-387-6344
Practice Address - Street 1:6850 LOWS RD
Practice Address - Street 2:SUITE 320
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-8708
Practice Address - Country:US
Practice Address - Phone:570-387-4368
Practice Address - Fax:570-387-6344
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000997L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017303160003Medicaid
PA0017303160003Medicaid