Healthcare Provider Details

I. General information

NPI: 1437064524
Provider Name (Legal Business Name): MCKINLEY MAES EDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N ANTHEM WAY
FLORENCE AZ
85132
US

IV. Provider business mailing address

2700 N ANTHEM WAY
FLORENCE AZ
85132-7124
US

V. Phone/Fax

Practice location:
  • Phone: 520-723-6400
  • Fax:
Mailing address:
  • Phone: 520-723-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4113065
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: