Macilvaine, Mary Lou

Macilvaine, Mary Lou is an sole proprietor health care provider with primary practice located at 4313 Ridgeway Dr , San Diego CA 92116-2052. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Health. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is her primary health care specialty. Macilvaine, Mary Lou can be contacted via phone (619) 501-0334.

Contact Information

Primary practice address
4313 Ridgeway Dr San Diego CA 92116-2052
Phone: (619) 501-0334
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 14409 California
Behavioral Health & Social Service Providers / Health 103TH0004X 14409 California

Profile Details

NPI number 1083879506
LBN Legal business name Macilvaine, Mary Lou
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 24th, 2008
Last updated Jul 24th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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