Provider Demographics
NPI:1811069107
Name:ST.JOHN, MARGARET S (PHD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:S
Last Name:ST.JOHN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 N CAMINO ABBEY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-2010
Mailing Address - Country:US
Mailing Address - Phone:520-299-2319
Mailing Address - Fax:
Practice Address - Street 1:6700 N CAMINO ABBEY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-2010
Practice Address - Country:US
Practice Address - Phone:520-299-2319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1116103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZOTHR0000Medicare UPIN