Healthcare Provider Details

I. General information

NPI: 1063414068
Provider Name (Legal Business Name): MARGARET S PENNINGTON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. MARGARET SUTHERLAND

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 11/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3861 E 3RD ST
TUCSON AZ
85716-4646
US

IV. Provider business mailing address

3861 E 3RD ST
TUCSON AZ
85716-4646
US

V. Phone/Fax

Practice location:
  • Phone: 520-325-8500
  • Fax: 520-325-3424
Mailing address:
  • Phone: 520-325-8500
  • Fax: 520-325-3424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0587
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: