Individual
THOMAS FRANCIS MCKENNA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1200 EUBANK BLVD NE, ALBUQUERQUE, NM 87112
(505) 271-5050
(505) 271-1080
Mailing address
1200 EUBANK BLVD NE, ALBUQUERQUE, NM 87112
(505) 271-5050
(505) 271-1080
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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