| S Mckenna, Llc | |
|
1601 Rainbow Rd Rogers AR 72758-8821 | |
| (479) 254-1144 | |
| (479) 254-1099 |
| Full Name | S Mckenna, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1601 Rainbow Rd, Rogers, Arkansas |
| Authorized Official Name and Position | Suzanne Mckenna (PSYCHOLOGIST) |
| Authorized Official Contact | 4792541144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S Mckenna, Llc 1601 Rainbow Rd Rogers AR 72758-8821 Ph: (479) 254-1144 | S Mckenna, Llc 1601 Rainbow Rd Rogers AR 72758-8821 Ph: (479) 254-1144 |
| NPI Number | 1154625127 |
|---|---|
| Provider Enumeration Date | 01/05/2011 |
| Last Update Date | 01/05/2011 |
| Medicare PECOS PAC ID | 3870773062 |
|---|---|
| Medicare Enrollment ID | O20110204000464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154625127 | NPI | - | NPPES |
| 498570209 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 10-07P (Arkansas) | Primary |
| Provider Name | Suzanne Mckenna |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316943095 PECOS PAC ID: 3173625753 Enrollment ID: I20110204000505 |
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