Provider Demographics
NPI:1689741472
Name:TIMMERMAN, MARGARET LYNN (EDS LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:LYNN
Last Name:TIMMERMAN
Suffix:
Gender:F
Credentials:EDS LPC
Other - Prefix:MRS
Other - First Name:M
Other - Middle Name:LYNN
Other - Last Name:TIMMERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDS LPC
Mailing Address - Street 1:3821 LORNA ROAD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AZ
Mailing Address - Zip Code:35244-1035
Mailing Address - Country:US
Mailing Address - Phone:205-989-8333
Mailing Address - Fax:205-989-8339
Practice Address - Street 1:3821 LORNA ROAD
Practice Address - Street 2:SUITE 120
Practice Address - City:BIRMINGHAM
Practice Address - State:AZ
Practice Address - Zip Code:35244-1035
Practice Address - Country:US
Practice Address - Phone:205-989-8333
Practice Address - Fax:205-989-8339
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1116101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
51524719OtherFED OUT OF STATE BCBS
AL51094728OtherAL & NON FED BCBS
51524719OtherFED OUT OF STATE BCBS