Individual
MRS. MARY MAC LAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
514 S BROWN ST, SUITE 600, SPRINGFIELD, TN 37172-2937
(615) 982-0500
(615) 382-0501
Mailing address
514 S BROWN ST, SUITE 600, SPRINGFIELD, TN 37172-2937
(615) 982-0500
(615) 382-0501
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5160
TN
Other
Enumeration date
02/26/2015
Last updated
02/26/2015
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