Provider Demographics
NPI:1972652493
Name:MCLEOD, MARGARET CAROL (MFT)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:CAROL
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 OLIVER RD STE 193
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-3431
Mailing Address - Country:US
Mailing Address - Phone:707-421-5555
Mailing Address - Fax:
Practice Address - Street 1:1300 OLIVER RD STE 193
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-3431
Practice Address - Country:US
Practice Address - Phone:707-421-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35756106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist