MEDICARE: MEGAN LORA PENTON

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	103K00000X	Behavior Analyst	1-26-88443	LA

General Provider Information

NPI Number	:	1528915790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN LORA PENTON

Provider Business Mailing Address
First Line	:	316 FOUNTAIN ST
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70448-4522
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 FOUNTAIN ST
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70448-4522
Country	:	US
Telephone Number	:	985-237-0415
Fax Number	:

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

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “ MEGAN LORA PENTON ” Practice Location

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