Individual
DAN MCKINNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
125 N LAKE ST, MANISTIQUE, MI 49854-1234
(906) 341-2144
Mailing address
125 N LAKE ST, MANISTIQUE, MI 49854-1234
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
DM003506
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7509104120
BCBS
MI
Enumeration date
10/11/2006
Last updated
07/08/2007
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