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Individual

MRS. MARY MARGARET MCCREERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.D.

Contact information

Practice address
113 W HICKORY ST, NEOSHO, MO 64850-1705
(417) 347-4309
(417) 347-9268
Mailing address
12713 HIGHWAY M, STARK CITY, MO 64866-8053
(417) 850-2013
(417) 347-9268

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2002008087
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20020080887
STATE COMMITTE OF DIETITIAN LICENSED
MO
01
2041-0267
CERTIFIED DIABETES EDUCATOR
01
916277
REGISTAR DIETITAN LICENSE
MO
Enumeration date
07/23/2010
Last updated
08/24/2010
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