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General NPI Number Information
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NPI Number | 1740712959
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Entity Type | Individual
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Provider Name | MEGAN MCPEAK DAVIS
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Gender | Female
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Dates
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Enumeration Date | 03/28/2017
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 3925 OLD LEE HWY STE 52A
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City | FAIRFAX
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State | VA
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Zip | 22030-2426
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Country | US
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Telephone | 571-354-0844
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Fax |
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Provider Business Mailing Address
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Address Line | 6574 STONEWAY CT
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City | BURKE
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State | VA
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Zip | 22015-4164
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Country | US
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Telephone | 571-318-3290
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 0803000240
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License Number State | VA
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