| NPI | 1336660489 |
|---|---|
| Former Name | JOEY RAY MCKINNEY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC CO12357) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P011716) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2022-09-06 |