Provider Demographics
NPI:1255701017
Name:MCINERNEY, MARY
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:
Last Name:MCINERNEY
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 1:9767 POPLAR PL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-6839
Mailing Address - Country:US
Mailing Address - Phone:407-816-8084
Mailing Address - Fax:
Practice Address - Street 1:9767 POPLAR PL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-6839
Practice Address - Country:US
Practice Address - Phone:407-816-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical