Individual
MARGARET KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3449 E REZANOF DR, INFANT LEARNING PROGRAM, KODIAK, AK 99615-6952
(907) 486-1374
(907) 486-4829
Mailing address
3449 E REZANOF DR, INFANT LEARNING PROGRAM, KODIAK, AK 99615-6952
(907) 486-1374
(907) 486-4829
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG225
—
AK
Enumeration date
09/02/2010
Last updated
09/02/2010
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