MEDICARE: MEGAN MARIE MEEHAN M.A.

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	106H00000X	Marriage & Family Therapist	96513	CA

General Provider Information

NPI Number	:	1598059800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MARIE MEEHAN M.A.

Provider Business Mailing Address
First Line	:	2660 VICTOR AVE
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96002-1432
Country	:	US
Telephone Number	:	530-223-5122
Fax Number	:

Provider Business Practice Location Address
First Line	:	717 PINE ST
Second Line	:
City	:	RED BLUFF
State	:	CA
Zip	:	96080-3743
Country	:	US
Telephone Number	:	530-528-0226
Fax Number	:

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

Provider Enumeration Date	:	06/03/2011
Last Update Date	:	11/04/2016

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