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General NPI Number Information
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NPI Number | 1013276013
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Entity Type | Organization
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Legal Business Name | MARGARET A. MACDEVITT PH.D, PC
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 05/29/2012
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Provider Practice Location Address
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Address Line | 123 E ARCH ST
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City | MARQUETTE
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State | MI
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Zip | 49855-3801
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Country | US
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Telephone | 906-226-9584
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Fax | 906-228-8057
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Provider Business Mailing Address
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Address Line | 123 E ARCH ST
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City | MARQUETTE
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State | MI
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Zip | 49855-3801
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Country | US
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Telephone | 906-226-9584
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Fax | 906-228-8057
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Authorized Official
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Title or Position | OWNER/ DOLEPROPRIETOR
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Name | MARGARET A MACDEVITT
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Credential | PH.D.
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Telephone | 906-226-9584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301005893
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License Number State | MI
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