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Individual

MARY M MCKAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CADC LLL

Contact information

Practice address
301 E SAINT JOSEPH ST, GREEN BAY, WI 54301-2241
(920) 433-3630
Mailing address
301 E SAINT JOSEPH ST, GREEN BAY, WI 54301-2241
(920) 433-3630

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11588
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39392300
WI
Enumeration date
05/21/2007
Last updated
07/09/2007
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