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Individual

MARY LYNNE MACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
5635 N SCOTTSDALE RD STE 170, SCOTTSDALE, AZ 85250-5945
(480) 737-6076
Mailing address
1647 N SIERRA VISTA DR, TEMPE, AZ 85288-1462
(480) 737-6076

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2598-057
WI
103T00000X
Psychologist
PSY-005478
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40916300
WI
Enumeration date
07/12/2006
Last updated
03/29/2026
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