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NPI Code Detail

MEDICARE: MEGAN CONNELL MA, BCBA, LBA

MEDICARE: MEGAN CONNELL MA, BCBA, LBA
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
1103K00000XBehavior Analyst4023TX

General Provider Information

NPI Number : 1437738077
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN CONNELL MA, BCBA, LBA
Provider Business Mailing Address
First Line : 1652 KELLER PKWY STE 200
Second Line :
City : KELLER
State : TX
Zip : 76248-3877
Country : US
Telephone Number : 682-291-9910
Fax Number :
Provider Business Practice Location Address
First Line : 1652 KELLER PKWY STE 200
Second Line :
City : KELLER
State : TX
Zip : 76248-3877
Country : US
Telephone Number : 682-291-9910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2021
Last Update Date : 04/02/2021

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