Provider Demographics
NPI:1417159559
Name:MCKINNEY, KRISTIN LEANNE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEANNE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 TRAEMOOR VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5054
Mailing Address - Country:US
Mailing Address - Phone:615-293-6455
Mailing Address - Fax:
Practice Address - Street 1:11 BURTON HILLS BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-6156
Practice Address - Country:US
Practice Address - Phone:615-665-3748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist