Individual
MS. MARY IRENE MCGINNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2311 PARK AVE, UNIT 3 SUITE 12, BURLEY, ID 83318-2170
(208) 678-3555
Mailing address
401 E 6TH ST, RUPERT, ID 83350-1723
(208) 670-0027
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW24487
ID
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
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