Provider Demographics
NPI:1376698100
Name:BUTKEREIT, MARGARET ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ANN
Last Name:BUTKEREIT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 SPRING CREEK DR
Mailing Address - Street 2:APARTMENT 4
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-1749
Mailing Address - Country:US
Mailing Address - Phone:607-735-3563
Mailing Address - Fax:607-735-3569
Practice Address - Street 1:100 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2849
Practice Address - Country:US
Practice Address - Phone:607-735-3563
Practice Address - Fax:607-735-3569
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016607103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist