Provider Demographics
NPI:1083227557
Name:MCKINLEY, WILLIAM CHRISTOPHER SCOTT (COTA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHRISTOPHER SCOTT
Last Name:MCKINLEY
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 KINGS RD APT 2156
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-7421
Mailing Address - Country:US
Mailing Address - Phone:214-914-4771
Mailing Address - Fax:
Practice Address - Street 1:2727 KINGS RD APT 2156
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-7421
Practice Address - Country:US
Practice Address - Phone:214-914-4771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44086224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant