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Individual
SANDRA MARY MCKINNEY
Active
Individual
SANDRA MARY MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LMFT
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34000232A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069913
SIHO PROVIDER NUMBER
IN
01
—
487861
ANTHEM PROVIDER NUMBER
IN
Enumeration date
02/15/2007
Last updated
02/21/2018
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