Provider Demographics
NPI:1093825531
Name:MCNABB, EDITH PAULA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:EDITH
Middle Name:PAULA
Last Name:MCNABB
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 WOOLEYS LN
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2328
Mailing Address - Country:US
Mailing Address - Phone:516-466-2316
Mailing Address - Fax:
Practice Address - Street 1:81 WOOLEYS LN
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2328
Practice Address - Country:US
Practice Address - Phone:516-466-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO128711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical