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General NPI Number Information
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NPI Number | 1386344380
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Entity Type | Individual
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Provider Name | WANDA RENEE WASHINGTON MCKINLEY LPC-ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 102 YMCA DR
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City | WAXAHACHIE
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State | TX
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Zip | 75165-5123
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Country | US
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Telephone | 214-966-5152
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Fax |
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Provider Business Mailing Address
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Address Line | 2824 MCCORMICK DR
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City | LANCASTER
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State | TX
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Zip | 75134-1999
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Country | US
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Telephone | 214-966-5152
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 89219
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License Number State | TX
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