Provider Demographics
NPI:1679602908
Name:YAVIL, MARGARET KATHLEEN
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:KATHLEEN
Last Name:YAVIL
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:S
Other - Last Name:YAVIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:351 BAIRD RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1414
Mailing Address - Country:US
Mailing Address - Phone:610-664-9958
Mailing Address - Fax:
Practice Address - Street 1:630 FAIRVIEW RD
Practice Address - Street 2:SUITE 207
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-2334
Practice Address - Country:US
Practice Address - Phone:610-544-9038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006491-L103TC0700X
PA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7811401OtherAETNA PIN#
PA0773633000OtherPERSONAL CHOICE PIN#
PA200202OtherCOMPPSYCH ID#
PA11633775OtherAETNA RECREDENTIALING#
PA554230OtherVALUE OPTIONS PROVIDER#