Individual
DR. JACK BASDEN MCKINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3412 HILLSBOROUGH ST, RALEIGH, NC 27607-5407
(919) 803-1369
Mailing address
3412 HILLSBOROUGH ST, RALEIGH, NC 27607-5407
(919) 803-1369
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
92
NC
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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