Provider Demographics
NPI:1730495664
Name:MCKINLEY, GRACE L (MHS)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:L
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9175 LAS VEGAS BLVD S
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-3359
Mailing Address - Country:US
Mailing Address - Phone:702-240-9355
Mailing Address - Fax:
Practice Address - Street 1:9175 LAS VEGAS BLVD S
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-3359
Practice Address - Country:US
Practice Address - Phone:702-240-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health