Mckernan, Colleen Therese

Mckernan, Colleen Therese is an individual health care provider with primary practice located at 602 Vonderburg Dr Suite 201, Brandon FL 33511-5900. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Mckernan, Colleen Therese can be contacted via phone (813) 653-1149.

Contact Information

Primary practice address
602 Vonderburg Dr Suite 201 Brandon FL 33511-5900
Phone: (813) 653-1149
Fax: (813) 654-6644
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 2873-154 Wisconsin
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA10880 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X SA10880 Florida

Profile Details

NPI number 1538299581
LBN Legal business name Mckernan, Colleen Therese
Credentials MS CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2007
Last updated Nov 8th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538299581 NPPES
Florida MEDICAID 004177900
Florida MEDICAID 830085200

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