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General NPI Number Information
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NPI Number | 1447381272
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Entity Type | Individual
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Provider Name | MEGAN M FITZGERALD MSW, PLCSW
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8730 MARVISTA DR
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City | SAINT LOUIS
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State | MO
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Zip | 63114-4308
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Country | US
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Telephone | 573-424-7987
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Fax | 314-535-0756
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Provider Business Mailing Address
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Address Line | 7711 THETFORD CT
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City | SAINT LOUIS
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State | MO
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Zip | 63119-5064
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Country | US
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Telephone | 573-424-7987
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Fax | 314-535-3003
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2005039201
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License Number State | MO
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