Healthcare Provider Details

I. General information

NPI: 1689741472
Provider Name (Legal Business Name): MARGARET LYNN TIMMERMAN EDS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: M LYNN TIMMERMAN EDS LPC

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3821 LORNA ROAD SUITE 120
BIRMINGHAM AZ
35244-1035
US

IV. Provider business mailing address

3821 LORNA ROAD SUITE 120
BIRMINGHAM AZ
35244-1035
US

V. Phone/Fax

Practice location:
  • Phone: 205-989-8333
  • Fax: 205-989-8339
Mailing address:
  • Phone: 205-989-8333
  • Fax: 205-989-8339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1116
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: