Provider Demographics
NPI:1275297079
Name:MCLEAN, SAVANNAH RUTH
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:RUTH
Last Name:MCLEAN
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 1:8606 WEBER CT APT A
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-8667
Mailing Address - Country:US
Mailing Address - Phone:412-735-8422
Mailing Address - Fax:
Practice Address - Street 1:73321 FRED WARING DR STE 101
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2890
Practice Address - Country:US
Practice Address - Phone:760-565-2701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician