Individual
MARY ALLEN MCBRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
940 EBENEZER BLVD, MADISON, MS 39110-6002
(601) 790-0583
Mailing address
940 EBENEZER BOULEVARD, MADISON, MS 39110
(601) 573-2617
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2985
MS
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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