Provider Demographics
NPI:1699767913
Name:MCKINNIE, SHEILA TERESA
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:TERESA
Last Name:MCKINNIE
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 1:1102 WRIGHT CIR
Mailing Address - Street 2:P. O. BOX 586
Mailing Address - City:LOUISVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30434-6523
Mailing Address - Country:US
Mailing Address - Phone:478-625-9426
Mailing Address - Fax:
Practice Address - Street 1:1102 WRIGHT CIR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:GA
Practice Address - Zip Code:30434-6523
Practice Address - Country:US
Practice Address - Phone:478-625-9426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker