Provider Demographics
NPI:1679554638
Name:HADER, MARGARET
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:
Last Name:HADER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:WEID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 SAINT CLAIR RIVER DR
Mailing Address - Street 2:
Mailing Address - City:ALGONAC
Mailing Address - State:MI
Mailing Address - Zip Code:48001-1802
Mailing Address - Country:US
Mailing Address - Phone:810-794-4982
Mailing Address - Fax:810-794-4407
Practice Address - Street 1:555 SAINT CLAIR RIVER DR
Practice Address - Street 2:
Practice Address - City:ALGONAC
Practice Address - State:MI
Practice Address - Zip Code:48001-1802
Practice Address - Country:US
Practice Address - Phone:810-794-4982
Practice Address - Fax:810-794-4407
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801002388104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP16330004Medicare ID - Type Unspecified