Provider Demographics
NPI:1275747115
Name:MCNABB, MARYJANE (MSW)
Entity Type:Individual
Prefix:
First Name:MARYJANE
Middle Name:
Last Name:MCNABB
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MARYJANE
Other - Middle Name:
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:102 E RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-7329
Mailing Address - Country:US
Mailing Address - Phone:812-333-6324
Mailing Address - Fax:812-331-6700
Practice Address - Street 1:550 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2165
Practice Address - Country:US
Practice Address - Phone:812-333-6324
Practice Address - Fax:812-331-6700
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker