Provider Demographics
NPI:1376797928
Name:MORAN, MARGARET DOLAN
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:DOLAN
Last Name:MORAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:52 CHARWILL DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON CORNERS
Mailing Address - State:NY
Mailing Address - Zip Code:12514-2515
Mailing Address - Country:US
Mailing Address - Phone:845-266-5109
Mailing Address - Fax:
Practice Address - Street 1:52 CHARWILL DR
Practice Address - Street 2:
Practice Address - City:CLINTON CORNERS
Practice Address - State:NY
Practice Address - Zip Code:12514-2515
Practice Address - Country:US
Practice Address - Phone:845-266-5109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006078235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist