Provider Demographics
NPI:1508222191
Name:MOYNAGH, MARGARET ANGELA (MED)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANGELA
Last Name:MOYNAGH
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LESLIE LN
Mailing Address - Street 2:
Mailing Address - City:HARWICH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02646-1311
Mailing Address - Country:US
Mailing Address - Phone:413-813-9994
Mailing Address - Fax:
Practice Address - Street 1:31A WORKSHOP RD
Practice Address - Street 2:
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-1210
Practice Address - Country:US
Practice Address - Phone:413-813-9994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA101YA0400XOtherADDICTION COUNSELOR