Doctor Name: | DR. MARY JOY MCMACHEN |
NPI Number: | 1053336719 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 6301007147 |
Business Practice Address: | 6492 Pembrook Dr Westland, MI - 481857760 |
Business Phone Number: | 7345958077 |
Business Fax Number: | 8452303285 |
Mailing Address: | 6492 Pembrook Dr, WESTLAND |
State: | MI |
Postal Code: | 481857760 |
Phone Number: | 7345958077 |
Fax Number: | 8452303285 |
NPI Enumeration Date: | 07/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6301007147 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |