Provider Demographics
NPI:1508461823
Name:SEICSHNAYDRE, MARGARET WALTON (MED)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:WALTON
Last Name:SEICSHNAYDRE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:STEVENS
Other - Last Name:WALTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:
Practice Address - Street 1:2173 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655
Practice Address - Country:US
Practice Address - Phone:662-234-6553
Practice Address - Fax:662-234-6555
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP0696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional