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General NPI Number Information
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NPI Number | 1093994519
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Entity Type | Individual
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Provider Name | MEGHAN MACLELLAN MSECE, CEIS
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Gender | Female
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 64 INDUSTRIAL PARK RD
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City | PLYMOUTH
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State | MA
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Zip | 02360-4881
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Country | US
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Telephone | 508-747-2012
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Fax | 508-747-4898
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Provider Business Mailing Address
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Address Line | 19 COURT ST APT 3C
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City | PLYMOUTH
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State | MA
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Zip | 02360-3370
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Country | US
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Telephone | 508-747-6361
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | 376442
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License Number State | MA
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