Individual
MS. MARY CORLISS MCCARTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 559-0473
(508) 427-5361
Mailing address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 559-0473
(508) 427-5361
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
2743
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2743
PROFESSIONAL CHILD CARE QUALIFICATION REGISTRY
MA
Enumeration date
02/09/2010
Last updated
02/09/2010
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