Provider Demographics
NPI:1851465249
Name:HARRISON, MARGARET VIRGINIA (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:VIRGINIA
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:MRS
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED, LPC
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:GUSTINE
Mailing Address - State:TX
Mailing Address - Zip Code:76455-0001
Mailing Address - Country:US
Mailing Address - Phone:325-667-0037
Mailing Address - Fax:325-667-0047
Practice Address - Street 1:206 E, MAIN
Practice Address - Street 2:
Practice Address - City:GUSTINE
Practice Address - State:TX
Practice Address - Zip Code:76455
Practice Address - Country:US
Practice Address - Phone:325-667-0037
Practice Address - Fax:325-667-0047
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16734101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional