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Individual

MS. MARINA MACGILLIVRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6515 WATTS RD, MADISON, WI 53719-2726
(262) 893-0769
Mailing address
6515 WATTS RD, MADISON, WI 53719-2726
(262) 893-0769

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
11729
WV
1041C0700X
Clinical Social Worker
Primary
11729
WI

Other

Enumeration date
02/26/2020
Last updated
07/30/2024
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