Provider Demographics
NPI:1164629663
Name:DAYNE, MARGARET N (MA)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:N
Last Name:DAYNE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 CRESTGLEN ROAD
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-2178
Mailing Address - Country:US
Mailing Address - Phone:626-335-7372
Mailing Address - Fax:626-335-5896
Practice Address - Street 1:636 CRESTGLEN ROAD
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-2178
Practice Address - Country:US
Practice Address - Phone:626-335-7372
Practice Address - Fax:626-335-5896
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP129235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP1290OtherMEDI CAL
CAP17277OtherREGIONAL CENTER