Provider Demographics
NPI:1356852107
Name:OVERLEY, MARGARET AILEEN (CT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:AILEEN
Last Name:OVERLEY
Suffix:
Gender:F
Credentials:CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 S MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-4740
Mailing Address - Country:US
Mailing Address - Phone:419-352-4624
Mailing Address - Fax:419-354-1774
Practice Address - Street 1:1084 S MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-4740
Practice Address - Country:US
Practice Address - Phone:419-352-4624
Practice Address - Fax:419-354-1774
Is Sole Proprietor?:No
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1500083-TRNE101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor