Provider Demographics
NPI:1790130649
Name:MCKINLEY, BRIGETTE (PEER SUPPORT)
Entity Type:Individual
Prefix:
First Name:BRIGETTE
Middle Name:
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:PEER SUPPORT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3439 BUCKHORN DR
Mailing Address - Street 2:STE. 160
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-1716
Mailing Address - Country:US
Mailing Address - Phone:859-721-1634
Mailing Address - Fax:
Practice Address - Street 1:3439 BUCKHORN DR
Practice Address - Street 2:STE. 160
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-1716
Practice Address - Country:US
Practice Address - Phone:859-721-1634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist