Provider Demographics
NPI:1306254552
Name:FOX, MARGARET KOEPKE (PHD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:KOEPKE
Last Name:FOX
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:FOX
Other - Last Name:KOEPKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 MARSH ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2132
Mailing Address - Country:US
Mailing Address - Phone:617-620-2810
Mailing Address - Fax:
Practice Address - Street 1:1130 MASSACHUSETTS AVE
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5258
Practice Address - Country:US
Practice Address - Phone:617-631-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9918103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service