=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871647446
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET P. WALLING MFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 42600 BOB HOPE DR SUITE 407
-----------------------------------------------------
City | RANCHO MIRAGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92270-4491
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-773-7333
-----------------------------------------------------
Fax | 760-771-2972
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 796
-----------------------------------------------------
City | LA QUINTA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92247-0796
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-773-7333
-----------------------------------------------------
Fax | 760-771-2972
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFC39281
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------