Healthcare Provider Details

I. General information

NPI: 1558677468
Provider Name (Legal Business Name): MEGHAN M LINES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGHAN DAVIS MCAULIFFE PHD

II. Dates (important events)

Enumeration Date: 08/30/2010
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ROCKLAND RD DIV. BEHAVIORAL HEALTH
WILMINGTON DE
19803-3607
US

IV. Provider business mailing address

1600 ROCKLAND RD DIV. BEHAVIORAL HEALTH
WILMINGTON DE
19803-3607
US

V. Phone/Fax

Practice location:
  • Phone: 302-651-4500
  • Fax: 302-651-4543
Mailing address:
  • Phone: 302-651-4500
  • Fax: 302-651-4543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberB20000325
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: