Provider Demographics
NPI:1295004273
Name:FAIRALL, MARGARET JEAN (LSW)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:JEAN
Last Name:FAIRALL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 MELVIN AVE N
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067-7530
Mailing Address - Country:US
Mailing Address - Phone:215-888-6014
Mailing Address - Fax:866-667-7744
Practice Address - Street 1:314 MELVIN AVE N
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-7530
Practice Address - Country:US
Practice Address - Phone:215-888-6014
Practice Address - Fax:866-667-7744
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW011702L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker