Healthcare Provider Details
I. General information
NPI: 1902533656
Provider Name (Legal Business Name): MEGAN ELIZABETH WHITE BCBA 1-25-78793
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/03/2022
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
604 N PIN OAK LN
MUNCIE IN
47304-3174
US
IV. Provider business mailing address
2125 W SURREY DR
MUNCIE IN
47304-1446
US
V. Phone/Fax
- Phone: 765-283-8086
- Fax:
- Phone: 765-283-8086
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | 0-22-13854 |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-25-78793 |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: