Individual
KELLY KEENAN MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
33 CHURCH ST STE 3, FREDONIA, NY 14063-1761
(716) 679-8599
Mailing address
119 TEMPLE ST, FREDONIA, NY 14063-1711
(716) 679-8599
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
805337
NY
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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