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General NPI Number Information
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NPI Number | 1174938153
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Entity Type | Organization
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Legal Business Name | MARGARET PEARSON
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 06/27/2014
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Provider Practice Location Address
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Address Line | 9015 W THURSTON AVE APT 4
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City | MILWAUKEE
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State | WI
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Zip | 53225-2842
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Country | US
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Telephone | 414-412-2458
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Fax |
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Provider Business Mailing Address
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Address Line | 9015 W THURSTON AVE APT 4
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City | MILWAUKEE
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State | WI
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Zip | 53225-2842
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Country | US
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Telephone | 414-412-2458
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Fax |
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Authorized Official
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Title or Position | LEGAL GUARDIAN
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Name | MARGARET PEARSON
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Credential |
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Telephone | 414-412-2758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | 1926627
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License Number State | WI
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