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General NPI Number Information
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NPI Number | 1831269364
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Entity Type | Individual
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Provider Name | DENESE MCDONALD LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 48TH MDG, RAF LAKENHEATH UNIT 5115
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City | APO
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State | AE
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Zip | 09461
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Country | US
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Telephone | 314-226-8124
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 50 BOX 52
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City | APO
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State | AE
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Zip | 09494-0001
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Country | US
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Telephone | 314-236-8566
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8075851-3501
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License Number State | UT
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