Provider Demographics
NPI:1184760514
Name:MARGULIES, ALLISON SIAN (PHD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:SIAN
Last Name:MARGULIES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4408 JOHN F KENNEDY PKWY APT B301
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3350
Mailing Address - Country:US
Mailing Address - Phone:301-642-3029
Mailing Address - Fax:
Practice Address - Street 1:300 BOARDWALK DR UNIT 5A
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3093
Practice Address - Country:US
Practice Address - Phone:970-223-2256
Practice Address - Fax:970-223-2324
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC2200X
COPSY3470103TM1800X
CO3470103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
12129278OtherCAQH
CO49825003Medicaid