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General NPI Number Information
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NPI Number | 1265557722
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Entity Type | Organization
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Legal Business Name | MARY JANE PRINGLE
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 03/05/2015
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Provider Practice Location Address
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Address Line | 3840 E LEE ST
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City | TUCSON
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State | AZ
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Zip | 85716-3721
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Country | US
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Telephone | 520-322-9184
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Fax |
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Provider Business Mailing Address
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Address Line | 2509 N CAMPBELL AVE 430
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City | TUCSON
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State | AZ
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Zip | 85719-3304
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Country | US
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Telephone | 520-322-9184
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Fax |
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Authorized Official
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Title or Position | SENIOR MEMBER, CLINICAL SUPERVISOR
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Name | MS. MARY JANE PRINGLE
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Credential | MSW, LCSW
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Telephone | 520-322-9184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-4075
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License Number State | AZ
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