Provider Demographics
NPI:1841587342
Name:MCLAREN, MARIA (OPTICIAN)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:MCLAREN
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20249 N 67TH AVE
Mailing Address - Street 2:B
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6843
Mailing Address - Country:US
Mailing Address - Phone:623-362-2600
Mailing Address - Fax:
Practice Address - Street 1:20249 N 67TH AVE
Practice Address - Street 2:B
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6843
Practice Address - Country:US
Practice Address - Phone:623-362-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ653I156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician