Provider Information for 1861050817
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GEORGETTE MCNALLY LPC
Sex: Female
NPI: 1861050817
Last Updated: 2019-06-11
Certification Date:
Certification Date:
Details
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| NPI | 1861050817 | ||||||||
| Enumeration Date | 2019-06-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6655 W GLENDALE AVE GLENDALE, AZ 85301-2358 United States Phone: 480-330-5428 | Fax: | ||||||||
| Primary Practice Address | 6655 W GLENDALE AVE GLENDALE, AZ 85301-2358 United States Phone: 026-192-1056 | Fax: | ||||||||
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