Provider Demographics
NPI:1417391640
Name:MCKINNEY, SONDRA
Entity Type:Individual
Prefix:
First Name:SONDRA
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 1:145 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:VENUS
Mailing Address - State:TX
Mailing Address - Zip Code:76084-3707
Mailing Address - Country:US
Mailing Address - Phone:402-519-0054
Mailing Address - Fax:
Practice Address - Street 1:145 JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:VENUS
Practice Address - State:TX
Practice Address - Zip Code:76084-3707
Practice Address - Country:US
Practice Address - Phone:402-519-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker