MEDICARE: MRS. MARGO SEIBERT M.S.

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	103TS0200X	School Psychologist	355	OH

General Provider Information

NPI Number	:	1588088561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGO SEIBERT M.S.

Provider Business Mailing Address
First Line	:	2424 WOODACRE DR
Second Line	:
City	:	HUDSON
State	:	OH
Zip	:	44236-1839
Country	:	US
Telephone Number	:	330-472-6212
Fax Number	:	330-644-1142

Provider Business Practice Location Address
First Line	:	2424 WOODACRE DR
Second Line	:
City	:	HUDSON
State	:	OH
Zip	:	44236-1839
Country	:	US
Telephone Number	:	330-472-6212
Fax Number	:	330-644-1142

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

Provider Enumeration Date	:	02/11/2014
Last Update Date	:	02/11/2014

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