Provider Demographics
NPI:1891063889
Name:PAUL, MARGARET L
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:L
Last Name:PAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:L
Other - Last Name:POLACEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:914 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2528
Mailing Address - Country:US
Mailing Address - Phone:850-747-5411
Mailing Address - Fax:
Practice Address - Street 1:914 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2528
Practice Address - Country:US
Practice Address - Phone:850-747-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health