Provider Demographics
NPI:1255830063
Name:HENRY, MARGARET REGINA
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:REGINA
Last Name:HENRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 HAVEMEYER PL
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6332
Mailing Address - Country:US
Mailing Address - Phone:914-575-7225
Mailing Address - Fax:
Practice Address - Street 1:112 HAVEMEYER PL
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6332
Practice Address - Country:US
Practice Address - Phone:914-575-7225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health