MEDICARE: MRS. MEGHAN NORA ARELLANO BA-CSCAD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	SC2337	MD

General Provider Information

NPI Number	:	1104394675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGHAN NORA ARELLANO BA-CSCAD

Provider Business Mailing Address
First Line	:	200 2ND AVE SW
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-3420
Country	:	US
Telephone Number	:	240-278-7494
Fax Number	:

Provider Business Practice Location Address
First Line	:	2610 GREENBRIAR LN
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-4424
Country	:	US
Telephone Number	:	240-278-7494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2018
Last Update Date	:	11/02/2018

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