Provider Demographics
NPI:1780336164
Name:SAMSON, MARGARET (MA QMHP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:SAMSON
Suffix:
Gender:F
Credentials:MA QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 EXECUTIVE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-1345
Mailing Address - Country:US
Mailing Address - Phone:618-688-4782
Mailing Address - Fax:
Practice Address - Street 1:8 EXECUTIVE DR STE 300
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-1345
Practice Address - Country:US
Practice Address - Phone:618-688-4782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator