Healthcare Provider Details

I. General information

NPI: 1962906099
Provider Name (Legal Business Name): MEEGAN HUSSAIN MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEEGAN JESSE

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 03/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 WALNUT ST STE 1350
PHILADELPHIA PA
19102-4019
US

IV. Provider business mailing address

1420 WALNUT ST STE 1350
PHILADELPHIA PA
19102-4019
US

V. Phone/Fax

Practice location:
  • Phone: 215-664-3200
  • Fax:
Mailing address:
  • Phone: 215-664-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number11220
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: