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General NPI Number Information
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NPI Number | 1558613257
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Entity Type | Individual
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Provider Name | MS. LEE ANN MCKENNA
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Gender | Female
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 1022 NORTH BROADWAY 2ND FLOOR
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City | YONKERS
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State | NY
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Zip | 10703-1280
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Country | US
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Telephone | 914-275-8364
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Fax |
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Provider Business Mailing Address
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Address Line | 50 GATEWAY RD. APT. 133S
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City | YONKERS
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State | NY
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Zip | 10703-1280
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Country | US
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Telephone | 914-423-4808
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R051247-1
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License Number State | NY
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