Provider Demographics
NPI:1114195385
Name:MCKINNEY, RICHA DEAN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:RICHA
Middle Name:DEAN
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6326 N SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-5012
Mailing Address - Country:US
Mailing Address - Phone:816-459-7873
Mailing Address - Fax:816-459-7873
Practice Address - Street 1:6326 N SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-5012
Practice Address - Country:US
Practice Address - Phone:816-459-7873
Practice Address - Fax:816-459-7873
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001018940225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist