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Individual

MS. MARY MARTHA MCCARTHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA OTRL

Contact information

Practice address
350 W A ST, SUITE 205, CASPER, WY 82601-1860
(307) 237-4477
(307) 237-6672
Mailing address
404 E 13TH ST, CASPER, WY 82601-4345
(307) 259-2986
(307) 237-6672

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR 568
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
314156
BLUE CROSS PROVIDER NUMBE
WY
Enumeration date
02/14/2007
Last updated
07/09/2007
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