Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6301016878 | MI |
NPI | 1114478278 |
---|---|
Provider Name | Trisha Nell Mckinney |
First Address | White Cloud, MI 49349-9426 |
Second Address | White Cloud, MI 49349-9426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2016 |
Last Update Date | 24/10/2016 |