Provider Demographics
NPI:1952565236
Name:MIROS, MARGARET GOSSE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:GOSSE
Last Name:MIROS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 S VALLEY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1450
Mailing Address - Country:US
Mailing Address - Phone:484-888-1980
Mailing Address - Fax:
Practice Address - Street 1:27 FAHNESTOCK RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-2104
Practice Address - Country:US
Practice Address - Phone:610-644-0426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000787101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional