Provider Demographics
NPI:1619008307
Name:MCKINLEY, MALIN (BA)
Entity Type:Individual
Prefix:MRS
First Name:MALIN
Middle Name:
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28720 CANWOOD ST STE 204
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4505
Mailing Address - Country:US
Mailing Address - Phone:747-334-2494
Mailing Address - Fax:
Practice Address - Street 1:28720 CANWOOD ST STE 204
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301
Practice Address - Country:US
Practice Address - Phone:747-334-2494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker