Healthcare Provider Details

I. General information

NPI: 1205552973
Provider Name (Legal Business Name): MEGAN ELIZABETH DWYER MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROOKLINE AVE
BOSTON MA
02215-5418
US

IV. Provider business mailing address

60 SAINT GERMAIN ST APT 5
BOSTON MA
02115-3211
US

V. Phone/Fax

Practice location:
  • Phone: 857-215-2329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: