MEDICARE: HEATHER MCGILVRAY

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1659777092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MCGILVRAY

Provider Business Mailing Address
First Line	:	107 MCGILVERY LN
Second Line	:
City	:	BOYD
State	:	TX
Zip	:	76023-3075
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1402 N CORINTH ST
Second Line	:
City	:	CORINTH
State	:	TX
Zip	:	76208-5445
Country	:	US
Telephone Number	:	940-597-5635
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2014
Last Update Date	:	11/12/2014

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Directions to “ HEATHER MCGILVRAY ” Practice Location

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