Healthcare Provider Details

I. General information

NPI: 1972873164
Provider Name (Legal Business Name): DELIGHT MEGREGIAN M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 SOLUTIONS WAY STE 120
ROCKLEDGE FL
32955-3623
US

IV. Provider business mailing address

515 E HALL RD
MERRITT ISLAND FL
32953-8412
US

V. Phone/Fax

Practice location:
  • Phone: 321-635-9535
  • Fax: 323-163-5917
Mailing address:
  • Phone: 321-684-3320
  • Fax: 321-635-9171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: