=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427178243
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET H BRIGGS CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 104 N MADISON AVE
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91101-1710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-793-0937
-----------------------------------------------------
Fax | 626-793-3352
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 104 N MADISON AVE
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91101-1710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-793-0937
-----------------------------------------------------
Fax | 626-793-3352
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SP 3607
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------