Provider Demographics
NPI:1083681944
Name:SEGRETO, MARY CHRISTINE (DO)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CHRISTINE
Last Name:SEGRETO
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:720 KENYON RD
Mailing Address - Street 2:NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC DBA UNITYPO
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-5759
Mailing Address - Country:US
Mailing Address - Phone:515-955-7171
Mailing Address - Fax:515-573-7898
Practice Address - Street 1:720 KENYON RD
Practice Address - Street 2:NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC DBA UNITYPO
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5759
Practice Address - Country:US
Practice Address - Phone:515-955-7171
Practice Address - Fax:515-573-7898
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA028062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0159608Medicaid
IA07466OtherWELLMARK BCBS