Provider Demographics
NPI:1093387979
Name:LANDRY, MARGARET ANN (LMSW, LSSW)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANN
Last Name:LANDRY
Suffix:
Gender:F
Credentials:LMSW, LSSW
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:LANDRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2007 WESTBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-5134
Mailing Address - Country:US
Mailing Address - Phone:315-393-6400
Mailing Address - Fax:
Practice Address - Street 1:225 MCCORD HALL
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38152-3330
Practice Address - Country:US
Practice Address - Phone:901-466-6689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10384104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker