Mary Decruise is a Clinical in Macon, Georgia. Mary Decruise practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary Decruise is 1679758429. The last update date is 2020-05-11.
Mary Decruise's current location address is 7040 Peake Rd N Unit 26012, Macon, Georgia. You can contact this provider via phone number 4782843985. The mailing address for Mary Decruise is 7040 Peake Rd N Unit 26012, Macon, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Decruise |
|---|---|
| Address | 7040 Peake Rd N Unit 26012, Macon, Georgia |
| Phone Number | 4782843985 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PSY.D |
NPI Number Detail
| NPI Number | 1679758429 |
|---|---|
| Provider Enumeration Date | 2007-12-28 |
| Last Updated Date | 2020-05-11 |
Provider Mailing Address Detail
| Address | 7040 Peake Rd N Unit 26012 |
|---|---|
| City | Macon |
| State | Georgia (GA) |
| Post Code | 312211001 |
| Phone Number | 4782843985 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 7636 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identifier code assigned to Mary Decruise by the Centers for Medicare & Medicaid Services?
The Mary Decruise has been issued the NPI (National Provider Identifier) 1679758429 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Mary Decruise?
The Mary Decruise is physically situated at 7040 Peake Rd N Unit 26012, in the city of Macon, state of GA, with the postal code 312211001.
What is the Mary Decruise's specialty and taxonomy code?
The Mary Decruise's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
When was the Mary Decruise's 1679758429 issued?
The Mary Decruise's 1679758429 was issued on 2007-12-28.
As of what date were the Mary Decruise's details last updated?
The information pertaining to the Mary Decruise, including its address, specialty, and other details, was most recently updated on 2020-05-11.
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