Provider Demographics
NPI:1710441472
Name:MCGARVEY, JEAN CATHERINE
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:CATHERINE
Last Name:MCGARVEY
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 1:105 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:CARMI
Mailing Address - State:IL
Mailing Address - Zip Code:62821-1348
Mailing Address - Country:US
Mailing Address - Phone:618-383-0202
Mailing Address - Fax:
Practice Address - Street 1:105 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:CARMI
Practice Address - State:IL
Practice Address - Zip Code:62821-1348
Practice Address - Country:US
Practice Address - Phone:618-383-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist