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General NPI Number Information
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NPI Number | 1184080756
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Entity Type | Individual
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Provider Name | LYLE MARGUERITE MARGO LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 832 FOLSOM ST STE 702
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-4502
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Country | US
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Telephone | 415-271-3278
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1911
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City | MILL VALLEY
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State | CA
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Zip | 94942-1911
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 121394
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License Number State | CA
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