Individual
THOMAS FRANCIS MCKENNA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0892
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00NM01R52X
BCBS OF NM
NM
01
—
027593
MHN MANAGED HEALTH CAP
CA
Enumeration date
11/14/2006
Last updated
07/08/2007
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