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Individual

MRS. MARY M MCARDLE-BIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4656 W JEFFERSON BLVD, 285, FORT WAYNE, IN 46804-6857
(260) 422-9372
(260) 422-0843
Mailing address
4656 W JEFFERSON BLVD, 285, FORT WAYNE, IN 46804-6857
(260) 422-9372
(260) 422-0843

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002936A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34002936A
LCSW
IN
01
35001048A
LMFT
IN
Enumeration date
12/26/2006
Last updated
07/08/2007
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