| Doctor Name: | MS. TINA MARIE MACKLIN |
| NPI Number: | 1417273210 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 7466 Hazel Ave Maplewood, MO - 631433028 |
| Business Phone Number: | 3143234032 |
| Business Fax Number: | 3143835453 |
| Mailing Address: | 7466 Hazel Ave, MAPLEWOOD |
| State: | MO |
| Postal Code: | 631433028 |
| Phone Number: | 3143234032 |
| Fax Number: | 3143835453 |
| NPI Enumeration Date: | 04/19/2010 |
| NPI Last Update Date: | 04/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |