Healthcare Provider Details

I. General information

NPI: 1053902080
Provider Name (Legal Business Name): MEGAN HAMEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31229 PLYMOUTH RD
LIVONIA MI
48150-2105
US

IV. Provider business mailing address

2868 FORT ST
LINCOLN PARK MI
48146-2424
US

V. Phone/Fax

Practice location:
  • Phone: 734-466-5150
  • Fax:
Mailing address:
  • Phone: 313-254-2913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401003374
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: