Healthcare Provider Details

I. General information

NPI: 1477531325
Provider Name (Legal Business Name): MARGARET THERESA SCOBORIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 S FEDERAL HWY SUITE 205
STUART FL
34994-2913
US

IV. Provider business mailing address

556 SW WOODCREEK DR
PALM CITY FL
34990-1858
US

V. Phone/Fax

Practice location:
  • Phone: 772-220-4755
  • Fax:
Mailing address:
  • Phone: 772-283-6389
  • Fax: 772-223-8131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW3027
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: