Individual
GINA MARIE MCMAHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
421 S PARK ST, HASTINGS, MI 49058-1636
(269) 948-0171
Mailing address
421 S PARK ST, HASTINGS, MI 49058-1636
(269) 948-0171
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301011002
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71976
—
MI
Enumeration date
01/07/2008
Last updated
01/18/2012
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