| Doctor Name: | MARY J HARRELL |
| NPI Number: | 1083890925 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 34003719A |
| Business Practice Address: | 255 N Miami St Wabash, IN - 469922705 |
| Business Phone Number: | 2605638446 |
| Business Fax Number: | 2605631902 |
| Mailing Address: | 850 N Harrison St, Attn: Anne Lawson WARSAW |
| State: | IN |
| Postal Code: | 465803163 |
| Phone Number: | 5742677169 |
| Fax Number: | 5742693995 |
| NPI Enumeration Date: | 01/10/2008 |
| NPI Last Update Date: | 01/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 34003719A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |