Provider Demographics
NPI:1063743763
Name:CALDWELL, MARGARET ANNETTA (NA)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANNETTA
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:NA
Other - Prefix:MRS
Other - First Name:MARGARET CALDWELL
Other - Middle Name:MARGARET
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BAPSRS
Mailing Address - Street 1:PO BOX 50401
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73140-5401
Mailing Address - Country:US
Mailing Address - Phone:405-741-8836
Mailing Address - Fax:
Practice Address - Street 1:1007 BELL DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-2707
Practice Address - Country:US
Practice Address - Phone:405-741-8836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health