MEDICARE: MARGARET FANNING MACDUFFIE L.M.H.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH3265	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538118641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET FANNING MACDUFFIE L.M.H.C.

Provider Business Mailing Address
First Line	:	435 S RIDGEWOOD AVE
Second Line	:	SUITE 105
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-4927
Country	:	US
Telephone Number	:	386-258-1700
Fax Number	:	386-672-0014

Provider Business Practice Location Address
First Line	:	435 S RIDGEWOOD AVE
Second Line	:	SUITE 105
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-4927
Country	:	US
Telephone Number	:	386-258-1700
Fax Number	:	386-672-0014

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	09/30/2008

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