Provider Demographics
NPI:1184604738
Name:RIBEIRO, MARGARET ANNE (MA)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ANNE
Last Name:RIBEIRO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4701 PINE ST PMB 170
Mailing Address - Street 2:SUITE K12
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-1816
Mailing Address - Country:US
Mailing Address - Phone:215-747-4990
Mailing Address - Fax:866-584-5614
Practice Address - Street 1:4701 PINE ST PMB 170
Practice Address - Street 2:SUITE K12
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-1816
Practice Address - Country:US
Practice Address - Phone:215-747-4990
Practice Address - Fax:866-584-5614
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2008-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005788L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA656069OtherHIGHMARK BLUE SHIELD
PA0783704000OtherBLUE CROSS PERSONAL CHOICE