Individual
ALLAN B MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDP
Contact information
Practice address
55 JOHN A CUMMINGS WAY, WOONSOCKET, RI 02895-3247
(401) 235-7000
Mailing address
165 BENJAMIN ST, PAWTUCKET, RI 02861-3221
(401) 725-9244
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PC225
RI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCS00190
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AM40912
—
RI
Enumeration date
09/27/2006
Last updated
11/24/2010
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