Provider Demographics
NPI:1154604924
Name:MACLIN, ERIN (PSY D)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:MACLIN
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 W VISTA ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5918
Mailing Address - Country:US
Mailing Address - Phone:417-597-4309
Mailing Address - Fax:417-763-3308
Practice Address - Street 1:2108 W VISTA ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5918
Practice Address - Country:US
Practice Address - Phone:417-597-4309
Practice Address - Fax:417-763-3308
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011032529103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical