Provider Demographics
NPI:1952520686
Name:MCKAY, SALLY KIM (MA,MS,MA, PHD)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:KIM
Last Name:MCKAY
Suffix:
Gender:F
Credentials:MA,MS,MA, PHD
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:KIM
Other - Last Name:ESPINOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 461
Mailing Address - Street 2:
Mailing Address - City:NEEDLES
Mailing Address - State:CA
Mailing Address - Zip Code:92363-0461
Mailing Address - Country:US
Mailing Address - Phone:760-903-3189
Mailing Address - Fax:
Practice Address - Street 1:301 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:NEEDLES
Practice Address - State:CA
Practice Address - Zip Code:92363-2937
Practice Address - Country:US
Practice Address - Phone:760-903-3189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool