Provider Demographics
NPI:1316618358
Name:PROPHETER, MARGARET CATHERINE
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:CATHERINE
Last Name:PROPHETER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 WILD ORCHID DR APT SUITE
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-1707
Mailing Address - Country:US
Mailing Address - Phone:410-322-1431
Mailing Address - Fax:
Practice Address - Street 1:5026 CAMPBELL BLVD STE H
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-5051
Practice Address - Country:US
Practice Address - Phone:410-780-2692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11917101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health