Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 1175 | MA |
NPI | 1003054719 |
---|---|
Provider Name | Ms. Magi Mckinnies |
First Address | Lexington, MA 02420-3721 |
Second Address | Lexington, MA 02420-3721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2009 |
Last Update Date | 03/02/2009 |