Provider Demographics
NPI:1790904126
Name:FEDOR, MARGARET HARRISON (LMHC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:HARRISON
Last Name:FEDOR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 N WALKER ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2146
Mailing Address - Country:US
Mailing Address - Phone:508-828-5845
Mailing Address - Fax:
Practice Address - Street 1:5 BANK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2312
Practice Address - Country:US
Practice Address - Phone:508-222-8812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5246101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5246OtherLMHC