Provider Demographics
NPI:1740991108
Name:MCKINNEY, TIANNA
Entity type:Individual
Prefix:
First Name:TIANNA
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 1:614 N WATER AVE APT 218
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-7316
Mailing Address - Country:US
Mailing Address - Phone:615-480-0928
Mailing Address - Fax:
Practice Address - Street 1:104 GLEN OAK BLVD STE 120
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6421
Practice Address - Country:US
Practice Address - Phone:615-637-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician