Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | R036767-1 | NY |
NPI | 1003169244 |
---|---|
Provider Name | Margo Linda Harrison Passarella |
First Address | Tucson, AZ 85715-3722 |
Second Address | Tucson, AZ 85713-3353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2012 |
Last Update Date | 25/10/2012 |