Healthcare Provider Details

I. General information

NPI: 1609914456
Provider Name (Legal Business Name): MARGARET ANN HUSTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 03/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 FREDERICA ST
OWENSBORO KY
42301
US

IV. Provider business mailing address

1316 FREDERICA ST
OWENSBORO KY
42301
US

V. Phone/Fax

Practice location:
  • Phone: 270-686-7999
  • Fax: 270-686-8092
Mailing address:
  • Phone: 270-686-7999
  • Fax: 270-686-8092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberKY 608 LCSW
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: