Individual
MS. MARY MCENELLY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
120 LABREE AVENUE SOUTH, NORTHWEST MEDICAL CENTER MENTAL HEALTH DIVISION, THIEF RIVER FALLS, MN 56701
(218) 683-4351
(218) 683-4362
Mailing address
120 LABREE AVENUE SOUTH, NORTHWEST MEDICAL CENTER MENTAL HEALTH DIVISION, THIEF RIVER FALLS, MN 56701
(218) 683-4351
(218) 683-4362
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9315
MN
Other
Enumeration date
04/22/2006
Last updated
07/08/2007
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