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General NPI Number Information
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NPI Number | 1831321397
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Entity Type | Individual
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Provider Name | MARGUERITE SHERWIN FREDERICK LISW
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Gender | Female
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 11900 FAIRHILL RD.
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City | CLEVELAND
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State | OH
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Zip | 44120-1053
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Country | US
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Telephone | 216-791-8000
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Fax | 121-637-3181
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Provider Business Mailing Address
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Address Line | 71 MORNINGSIDE DR
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City | CHAGRIN FALLS
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State | OH
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Zip | 44022-4234
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Country | US
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Telephone | 440-346-4101
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I0900050
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License Number State | OH
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