Provider Demographics
NPI:1831950211
Name:MCLAUGHLIN, MARY (DPT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11878 HUBBARD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1733
Mailing Address - Country:US
Mailing Address - Phone:734-953-1745
Mailing Address - Fax:734-953-1743
Practice Address - Street 1:11878 HUBBARD ST STE 100
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1733
Practice Address - Country:US
Practice Address - Phone:734-953-1745
Practice Address - Fax:734-953-1743
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501303128225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist