Individual
THERESA MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
CORNER OF ROUTES N12 & N7, FORT DEFIANCE, AZ 86504-8650
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8515
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
218376
NC
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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