Provider Demographics
NPI:1811099385
Name:GREENOUGH, MARGARET (MFT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:GREENOUGH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4144 WINDING WAY # 8
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-4413
Mailing Address - Country:US
Mailing Address - Phone:916-489-4103
Mailing Address - Fax:916-489-4103
Practice Address - Street 1:4144 WINDING WAY # 8
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4413
Practice Address - Country:US
Practice Address - Phone:916-489-4103
Practice Address - Fax:916-489-4103
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41360106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist