Provider Demographics
NPI:1275657546
Name:MCLAREN, SALLY E (PHD)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:E
Last Name:MCLAREN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:E
Other - Last Name:BOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 746
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42135-0746
Mailing Address - Country:US
Mailing Address - Phone:270-586-9100
Mailing Address - Fax:270-586-9140
Practice Address - Street 1:110 N MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-2143
Practice Address - Country:US
Practice Address - Phone:270-586-9100
Practice Address - Fax:270-586-9140
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0796103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0796OtherLICENSE