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General NPI Number Information
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NPI Number | 1003169244
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Entity Type | Individual
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Provider Name | MARGO LINDA HARRISON PASSARELLA LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 502 W 29TH ST
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City | TUCSON
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State | AZ
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Zip | 85713-3353
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Country | US
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Telephone | 520-838-3886
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Fax |
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Provider Business Mailing Address
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Address Line | 2495 N DESERT LINKS DR #17
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City | TUCSON
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State | AZ
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Zip | 85715-3722
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Country | US
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Telephone | 520-248-6326
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R036767-1
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License Number State | NY
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