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General NPI Number Information
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NPI Number | 1306978895
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Entity Type | Individual
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Provider Name | MARCI MCCAULAY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 130 N PROSPECT ST SUITE 9
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City | GRANVILLE
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State | OH
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Zip | 43023-1371
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Country | US
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Telephone | 740-587-1375
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 186
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City | GRANVILLE
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State | OH
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Zip | 43023-0186
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3459
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License Number State | OH
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