Provider Demographics
NPI:1235290156
Name:DEAU, MARGARET STANGL (RD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:STANGL
Last Name:DEAU
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19333 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-4132
Mailing Address - Country:US
Mailing Address - Phone:262-785-2271
Mailing Address - Fax:414-527-5721
Practice Address - Street 1:19333 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-4132
Practice Address - Country:US
Practice Address - Phone:262-785-2271
Practice Address - Fax:414-527-5721
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1710-029133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered