MEDICARE: MRS. SANDRA MCKAY BSN, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	495	GA

General Provider Information

NPI Number	:	1730394347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA MCKAY BSN, LMFT

Provider Business Mailing Address
First Line	:	1810 PEACHTREE INDUSTRIAL BLVD
Second Line	:	SUITE 233
City	:	DULUTH
State	:	GA
Zip	:	30097-8180
Country	:	US
Telephone Number	:	678-777-1037
Fax Number	:

Provider Business Practice Location Address
First Line	:	1810 PEACHTREE INDUSTRIAL BLVD
Second Line	:	SUITE 233
City	:	DULUTH
State	:	GA
Zip	:	30097-8180
Country	:	US
Telephone Number	:	678-777-1037
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	07/08/2007

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