Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 2014034182 | MO |
NPI | 1003197195 |
---|---|
Provider Name | Mary M Corrigan |
First Address | Clinton, MO 64735-8804 |
Second Address | Wentzville, MO 63385-4836 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2011 |
Last Update Date | 05/08/2019 |