Provider Demographics
NPI:1013458090
Name:MCCARY, MARIEA W
Entity Type:Individual
Prefix:
First Name:MARIEA
Middle Name:W
Last Name:MCCARY
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:PO BOX 676
Mailing Address - Street 2:
Mailing Address - City:WRIGHT CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74766-0676
Mailing Address - Country:US
Mailing Address - Phone:580-236-0157
Mailing Address - Fax:
Practice Address - Street 1:101 WEST 5TH STREET
Practice Address - Street 2:
Practice Address - City:WRIGHT CITY
Practice Address - State:OK
Practice Address - Zip Code:74766-0676
Practice Address - Country:US
Practice Address - Phone:580-236-0157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator