Provider Demographics
NPI:1720069800
Name:BIBB, MARGARET LOUISE (PSYD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:LOUISE
Last Name:BIBB
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LONGWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4522
Mailing Address - Country:US
Mailing Address - Phone:256-534-8161
Mailing Address - Fax:256-354-7254
Practice Address - Street 1:111 LONGWOOD DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4522
Practice Address - Country:US
Practice Address - Phone:256-534-8161
Practice Address - Fax:256-354-7254
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL820103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51026514OtherBLUE CROSS BLUE SHIELD
AL51500726OtherFEDERAL BLUE CROSS
ALS21922Medicare UPIN