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NPI Code Detail

MEDICARE: EMILY ANNE MCKENNA

MEDICARE: EMILY ANNE MCKENNA
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
1103T00000XPsychologist36322TX

General Provider Information

NPI Number : 1801149588
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY ANNE MCKENNA
Provider Business Mailing Address
First Line : 1219 BARRANCA DR
Second Line :
City : EL PASO
State : TX
Zip : 79935-4601
Country : US
Telephone Number : 915-779-5600
Fax Number : 915-779-5605
Provider Business Practice Location Address
First Line : 1219 BARRANCA DR
Second Line :
City : EL PASO
State : TX
Zip : 79935-4601
Country : US
Telephone Number : 915-779-5600
Fax Number : 915-779-5605
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2012
Last Update Date : 10/18/2012

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Directions to “ EMILY ANNE MCKENNA ” Practice Location

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