Healthcare Provider Details

I. General information

NPI: 1437177003
Provider Name (Legal Business Name): MARGARET GUNTHER MCNELLY MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30131 TOWN CENTER DR SUITE 104
LAGUNA NIGUEL CA
92677-2034
US

IV. Provider business mailing address

30131 TOWN CENTER DR SUITE 104
LAGUNA NIGUEL CA
92677-2034
US

V. Phone/Fax

Practice location:
  • Phone: 949-580-5613
  • Fax: 949-837-6364
Mailing address:
  • Phone: 949-580-5613
  • Fax: 949-837-6364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 35792
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: