Provider Demographics
NPI:1275022881
Name:DURST, MEGAN MARIE (BCBA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:DURST
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6260 HERMANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55810-9569
Mailing Address - Country:US
Mailing Address - Phone:218-481-8910
Mailing Address - Fax:
Practice Address - Street 1:6260 HERMANTOWN RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55810-9569
Practice Address - Country:US
Practice Address - Phone:218-481-8910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MN1-21-52506103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician