Healthcare Provider Details

I. General information

NPI: 1154538908
Provider Name (Legal Business Name): MARGARET MARY MCGUINNESS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 TRUMBULL ST
DETROIT MI
48216-1529
US

IV. Provider business mailing address

306 W TROY ST
FERNDALE MI
48220-1850
US

V. Phone/Fax

Practice location:
  • Phone: 313-256-7280
  • Fax:
Mailing address:
  • Phone: 248-543-6519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: