Healthcare Provider Details

I. General information

NPI: 1851175269
Provider Name (Legal Business Name): MEGAN STEVENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324R CLARK ST
WORCESTER MA
01606-1214
US

IV. Provider business mailing address

29 QUOBAUG AVE
OXFORD MA
01540-2120
US

V. Phone/Fax

Practice location:
  • Phone: 774-823-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: