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General NPI Number Information
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NPI Number | 1841542065
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Entity Type | Individual
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Provider Name | MEGAN VYLONIS
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Gender | Female
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 1130 12TH ST STE C
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City | MODESTO
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State | CA
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Zip | 95354-0834
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Country | US
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Telephone | 209-289-4271
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 I ST STE 200
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City | MODESTO
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State | CA
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Zip | 95354-1135
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Country | US
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Telephone | 209-525-5373
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 76751
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 100646
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License Number State | CA
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