Provider Demographics
NPI:1164038915
Name:MCGRATH, LUANNE JEAN
Entity Type:Individual
Prefix:
First Name:LUANNE
Middle Name:JEAN
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MALLARD CIR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-8108
Mailing Address - Country:US
Mailing Address - Phone:774-275-0554
Mailing Address - Fax:
Practice Address - Street 1:12 MALLARD CIR
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-8108
Practice Address - Country:US
Practice Address - Phone:774-275-0554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician