Individual
MARLY J MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
12231 ASHLEY DR # A, GULFPORT, MS 39503-2775
(228) 832-2400
(228) 832-2431
Mailing address
12231 ASHLEY DR # A, GULFPORT, MS 39503-2775
(228) 832-2400
(228) 832-2431
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M4678
MS
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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