Provider Demographics
NPI:1326282435
Name:ANDERSON, MARGARET KING (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:KING
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 OLIVIA ST
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-1735
Mailing Address - Country:US
Mailing Address - Phone:203-735-9975
Mailing Address - Fax:203-735-9975
Practice Address - Street 1:50 OLIVIA ST
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-1735
Practice Address - Country:US
Practice Address - Phone:203-735-9975
Practice Address - Fax:203-735-9975
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00401106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000401OtherSTATE OF CONNECTICUT