Provider Demographics
NPI:1356904650
Name:CORY, MARGARET ELIZABETH (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:CORY
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ELIZABETH
Other - Last Name:MCMAHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SOCIAL WORKER
Mailing Address - Street 1:3324 N SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2929
Mailing Address - Country:US
Mailing Address - Phone:414-630-8557
Mailing Address - Fax:
Practice Address - Street 1:3732 W WISCONSIN AVE STE 200
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-3166
Practice Address - Country:US
Practice Address - Phone:414-290-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI721-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker