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NPI Code Detail

MEDICARE: MARY MCCARNEY

MEDICARE: MARY MCCARNEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist1053MN

General Provider Information

NPI Number : 1942674619
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MCCARNEY
Provider Business Mailing Address
First Line : 8640 EAGLE CREEK CIR
Second Line :
City : SAVAGE
State : MN
Zip : 55378-4400
Country : US
Telephone Number : 952-746-7664
Fax Number : 952-224-4867
Provider Business Practice Location Address
First Line : 8640 EAGLE CREEK CIR
Second Line :
City : SAVAGE
State : MN
Zip : 55378-4400
Country : US
Telephone Number : 952-746-7664
Fax Number : 952-224-4867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2015
Last Update Date : 12/04/2015

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Directions to “ MARY MCCARNEY ” Practice Location

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