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General NPI Number Information
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NPI Number | 1922899616
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Entity Type | Individual
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Provider Name | MARY EY SO MSW, LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 5805 CALLAGHAN RD STE 206
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City | SAN ANTONIO
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State | TX
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Zip | 78228-1127
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Country | US
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Telephone | 734-649-3903
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Fax |
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Provider Business Mailing Address
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Address Line | 5805 CALLAGHAN RD STE 206
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City | SAN ANTONIO
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State | TX
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Zip | 78228-1127
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Country | US
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Telephone | 210-842-1777
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851119207
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 115193
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License Number State | TX
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