Provider Demographics
NPI:1043612336
Name:MCGLATHERY, TONIE MARIE (PSYS)
Entity Type:Individual
Prefix:MRS
First Name:TONIE
Middle Name:MARIE
Last Name:MCGLATHERY
Suffix:
Gender:F
Credentials:PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10335 DETROIT AVE APT 11B
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-1666
Mailing Address - Country:US
Mailing Address - Phone:440-666-0364
Mailing Address - Fax:216-295-4546
Practice Address - Street 1:3817 MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-2846
Practice Address - Country:US
Practice Address - Phone:216-491-5865
Practice Address - Fax:216-295-4546
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3175656103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool