Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 02966 | MD |
N | 103TC0700X | Clinical Psychologist | 02966 | MD |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 02966 | MD |
NPI | 1073634317 |
---|---|
Provider Name | Dr. Laura J Margolis |
First Address | Upperco, MD 21155-9755 |
Second Address | Ellicott City, MD 21043-4130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |