Provider Demographics
NPI:1770204570
Name:ROBERTS, MARGARET MARIE (NCPT)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MARIE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:NCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39382 TRILLIUM ST
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-5399
Mailing Address - Country:US
Mailing Address - Phone:503-826-3141
Mailing Address - Fax:
Practice Address - Street 1:39382 TRILLIUM ST
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-5399
Practice Address - Country:US
Practice Address - Phone:503-826-3141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2021260167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician