Healthcare Provider Details

I. General information

NPI: 1144701137
Provider Name (Legal Business Name): MEGHAN HANSEN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 HUGH HOWELL RD # 1192
TUCKER GA
30084-4721
US

IV. Provider business mailing address

4351 HUGH HOWELL RD # 1192
TUCKER GA
30084-4721
US

V. Phone/Fax

Practice location:
  • Phone: 770-872-6788
  • Fax:
Mailing address:
  • Phone: 770-872-6788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: