Provider Demographics
NPI:1467855114
Name:MAGYARI, PATRICIA ANN (MS)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:MAGYARI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1562 PARK LN UNIT B
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-1940
Mailing Address - Country:US
Mailing Address - Phone:443-939-0232
Mailing Address - Fax:
Practice Address - Street 1:1562 PARK LN UNIT B
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-1940
Practice Address - Country:US
Practice Address - Phone:443-939-0232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional