| Doctor Name: | MARY BETH MCDONOUGH |
| NPI Number: | 1265442495 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CSWR-R |
| License Number: | R045595-1 |
| Business Practice Address: | 476 Canisteo St Hornell, NY - 148439768 |
| Business Phone Number: | 6073243580 |
| Business Fax Number: | 6073243998 |
| Mailing Address: | 111 E 14th St, ELMIRA HEIGHTS |
| State: | NY |
| Postal Code: | 149031303 |
| Phone Number: | 6077349539 |
| Fax Number: | 6077346293 |
| NPI Enumeration Date: | 08/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R045595-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |