Provider Demographics
NPI:1043746035
Name:MCKINNEY, ANNA
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 FACULTY DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-3933
Mailing Address - Country:US
Mailing Address - Phone:937-430-7579
Mailing Address - Fax:
Practice Address - Street 1:323 N BROAD ST
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-4934
Practice Address - Country:US
Practice Address - Phone:937-318-8103
Practice Address - Fax:937-400-2347
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst