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General NPI Number Information
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NPI Number | 1760685457
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Entity Type | Individual
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Provider Name | MARGARET L. FALLSTICK LPC
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Gender | Female
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 500 S PENNSVILLE AUBURN RD
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City | PENNS GROVE
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State | NJ
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Zip | 08069-2936
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Country | US
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Telephone | 856-299-3200
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Fax | 856-299-7183
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Provider Business Mailing Address
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Address Line | 114 W CENTER ST
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City | CLAYTON
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State | NJ
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Zip | 08312-1414
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Country | US
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Telephone | 856-307-9107
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 37PC00186000
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License Number State | NJ
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