Individual
SUSAN M MACINTYRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
739 W PORTOBELLO AVE, MESA, AZ 85210-8345
(520) 416-4395
Mailing address
739 W PORTOBELLO AVE, MESA, AZ 85210-8345
(520) 416-4395
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18122
AZ
1041C0700X
Clinical Social Worker
19138
MT
Other
Enumeration date
12/05/2016
Last updated
07/17/2020
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