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NPI Code Detail

MEDICARE: MRS. MEGAN ROSALYN POLLOK BCBA

MEDICARE: MRS. MEGAN ROSALYN POLLOK BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1639485063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEGAN ROSALYN POLLOK BCBA
Provider Business Mailing Address
First Line : 924 PECAN TREE LN
Second Line :
City : FORT MILL
State : SC
Zip : 29715-7011
Country : US
Telephone Number : 407-451-8688
Fax Number : 772-675-9100
Provider Business Practice Location Address
First Line : 331 E MAIN ST STE 200
Second Line :
City : ROCK HILL
State : SC
Zip : 29730-5384
Country : US
Telephone Number : 855-832-6727
Fax Number : 772-675-9100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2010
Last Update Date : 08/11/2020

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