Provider Demographics
NPI:1215105218
Name:PRINGLE, MARY JANE (MSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:JANE
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 N CAMPBELL AVE
Mailing Address - Street 2:430
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-3304
Mailing Address - Country:US
Mailing Address - Phone:520-322-9184
Mailing Address - Fax:
Practice Address - Street 1:3840 E LEE ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3721
Practice Address - Country:US
Practice Address - Phone:520-322-9184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-40751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical