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NPI Code Detail

MEDICARE: MEGHAN COLEMAN WACLAWSKI BCBA

MEDICARE: MEGHAN COLEMAN WACLAWSKI BCBA
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 Analyst1054NC
2103K00000XBehavior AnalystBA60948501WA
3103K00000XBehavior Analyst1-13-13826CA

General Provider Information

NPI Number : 1851624761
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGHAN COLEMAN WACLAWSKI BCBA
Provider Business Mailing Address
First Line : PO BOX 33568
Second Line :
City : SAN DIEGO
State : CA
Zip : 92163-3568
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Provider Business Practice Location Address
First Line : 5333 MISSION CENTER RD STE 110
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1347
Country : US
Telephone Number : 552-237-1238
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2009
Last Update Date : 04/26/2024

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Directions to “ MEGHAN COLEMAN WACLAWSKI BCBA” Practice Location

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