Provider Demographics
NPI:1356076657
Name:DUXLER, MARGOT BETH (PHD)
Entity Type:Individual
Prefix:
First Name:MARGOT
Middle Name:BETH
Last Name:DUXLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5748 N HERMITAGE AVE UNIT 102
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-5779
Mailing Address - Country:US
Mailing Address - Phone:415-771-7567
Mailing Address - Fax:
Practice Address - Street 1:5748 N HERMITAGE AVE UNIT 102
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-5779
Practice Address - Country:US
Practice Address - Phone:415-771-7567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16309103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical