Provider Demographics
NPI:1558914838
Name:FITZGERALD, MARGARET THOMPSON
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:THOMPSON
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 S TRYON ST UNIT 1448
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4393
Mailing Address - Country:US
Mailing Address - Phone:203-605-9021
Mailing Address - Fax:
Practice Address - Street 1:1205 S TRYON ST UNIT 1448
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-4393
Practice Address - Country:US
Practice Address - Phone:203-605-9021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician