Individual
MARY MARGARET MAGINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3320 N CLINTON ST, FORT WAYNE, IN 46805-1918
(260) 483-2100
Mailing address
7811 WATERSEDGE CV, FORT WAYNE, IN 46804-7847
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22000930A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000080879
BLUE CROSS BLUE SHIELD
IN
Enumeration date
02/19/2007
Last updated
07/08/2007
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