Provider Demographics
NPI:1689430795
Name:MCKINNEY, JANEL (LMT)
Entity Type:Individual
Prefix:MS
First Name:JANEL
Middle Name:
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 1:1406 N 475 W
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:UT
Mailing Address - Zip Code:84015-2824
Mailing Address - Country:US
Mailing Address - Phone:801-529-2012
Mailing Address - Fax:
Practice Address - Street 1:887 MCCORMICK WAY
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-7262
Practice Address - Country:US
Practice Address - Phone:801-529-2012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
UT282686-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness Coach