Provider Demographics
NPI:1801660444
Name:MCKENNEY, BARBARA
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:MCKENNEY
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 1:369 DUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:NH
Mailing Address - Zip Code:03809-5224
Mailing Address - Country:US
Mailing Address - Phone:603-387-1877
Mailing Address - Fax:
Practice Address - Street 1:35 CENTER ST
Practice Address - Street 2:
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4324
Practice Address - Country:US
Practice Address - Phone:603-387-1877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8025225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty