Provider Demographics
NPI:1952917650
Name:WILLARD, MARGARET JANE (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:JANE
Last Name:WILLARD
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 15TH ST APT 2L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4849
Mailing Address - Country:US
Mailing Address - Phone:315-447-7851
Mailing Address - Fax:
Practice Address - Street 1:167 15TH ST APT 2L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4849
Practice Address - Country:US
Practice Address - Phone:315-447-7851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool