Provider Demographics
NPI:1770892564
Name:WEIR, MARGARET MORAN
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:MORAN
Last Name:WEIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 POTRERO ST
Mailing Address - Street 2:SUITE 42-103
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2741
Mailing Address - Country:US
Mailing Address - Phone:408-507-2352
Mailing Address - Fax:
Practice Address - Street 1:303 POTRERO ST
Practice Address - Street 2:SUITE 42-103
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2741
Practice Address - Country:US
Practice Address - Phone:408-507-2352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAN7387492OtherDRIVER'S LICENSE