Provider Demographics
NPI:1871647446
Name:WALLING, MARGARET P (MFT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:P
Last Name:WALLING
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 796
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92247-0796
Mailing Address - Country:US
Mailing Address - Phone:760-773-7333
Mailing Address - Fax:760-771-2972
Practice Address - Street 1:42600 BOB HOPE DR
Practice Address - Street 2:SUITE 407
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4491
Practice Address - Country:US
Practice Address - Phone:760-773-7333
Practice Address - Fax:760-771-2972
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39281106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33BG4MOtherRCDMH
CA33BGEMOtherRCDMH