Provider Demographics
NPI:1598532921
Name:POTTER, MARGARET TICKNOR (MA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:TICKNOR
Last Name:POTTER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 KAY CIR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-1627
Mailing Address - Country:US
Mailing Address - Phone:484-883-6165
Mailing Address - Fax:
Practice Address - Street 1:1225 KAY CIR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-1627
Practice Address - Country:US
Practice Address - Phone:484-883-6165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health