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General NPI Number Information
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NPI Number | 1033734702
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Entity Type | Organization
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Legal Business Name | CM KINNEY AND ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 623 MERAMEC STATION RD
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City | MANCHESTER
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State | MO
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Zip | 63021-5550
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Country | US
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Telephone | 314-266-9131
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Fax |
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Provider Business Mailing Address
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Address Line | 1237 WARSON WOODS DR
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City | SAINT LOUIS
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State | MO
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Zip | 63122-1735
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Country | US
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Telephone | 314-608-2527
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Fax |
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Authorized Official
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Title or Position | ADMIM
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Name | VICTORIA SHEPHERD
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Credential |
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Telephone | 314-315-5148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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