Individual
MARY MCKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
2300 E 6TH AVE, FLAGSTAFF, AZ 86004-4247
(928) 773-4084
Mailing address
111 E OAK AVE APT 4, FLAGSTAFF, AZ 86001-1447
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0661
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LIC-0661
LIC. PROFE.COUNSDLOR
AZ
Enumeration date
04/18/2007
Last updated
07/08/2007
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