MEDICARE: MEGHAN HAVLIN

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	221700000X	Art Therapist	243759	KY

General Provider Information

NPI Number	:	1164055752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN HAVLIN

Provider Business Mailing Address
First Line	:	5639 MACEY AVE APT E11
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-2131
Country	:	US
Telephone Number	:	513-460-2642
Fax Number	:

Provider Business Practice Location Address
First Line	:	5725 DRAGON WAY STE 115
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-4519
Country	:	US
Telephone Number	:	513-460-2642
Fax Number	:

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

Provider Enumeration Date	:	02/21/2020
Last Update Date	:	02/21/2020

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Directions to “ MEGHAN HAVLIN ” Practice Location

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