Provider Demographics
NPI:1952923807
Name:GREGOR, MARGO (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARGO
Middle Name:
Last Name:GREGOR
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 1:2143 LARCHDALE DR
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4301 DARROW RD STE 3500
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2686
Practice Address - Country:US
Practice Address - Phone:234-208-6299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.07993103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling