Individual
MARVIN O MCCLARTY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7215 ONTARIO ST, OMAHA, NE 68124-3574
(208) 605-7070
Mailing address
1650 S TOPAZ WAY, MERIDIAN, ID 83642-4474
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1107
NE
Other
Enumeration date
08/12/2021
Last updated
10/05/2021
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