Provider Demographics
NPI:1891063889
Name:PAUL, MARGARET L
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:L
Last Name:PAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:L
Other - Last Name:POLACEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:653 W 23RD ST # 513
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3922
Mailing Address - Country:US
Mailing Address - Phone:850-612-8379
Mailing Address - Fax:
Practice Address - Street 1:653 W 23RD ST # 513
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3922
Practice Address - Country:US
Practice Address - Phone:850-612-8379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MH13218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health