Provider Demographics
NPI:1033379797
Name:ANDERSON, MARGARET CHESNEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:CHESNEY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:ANN
Other - Last Name:CHESNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:29 S PACA ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1771
Mailing Address - Country:US
Mailing Address - Phone:410-328-2832
Mailing Address - Fax:
Practice Address - Street 1:2200 KERNAN DR FL 2
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-6665
Practice Address - Country:US
Practice Address - Phone:410-448-6493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03970103T00000X
CAPSY 5698103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD03970OtherPSYCHOLOGIST LICENSE NUMBER
CAPSY 5698OtherPSYCHOLOGIST LICENSE NUMBER