Provider Demographics
NPI:1457872343
Name:CATANIA, MEGAN ALYSE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ALYSE
Last Name:CATANIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 WOODRUFF AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06787-1549
Mailing Address - Country:US
Mailing Address - Phone:860-484-9144
Mailing Address - Fax:
Practice Address - Street 1:39 WOODRUFF AVE
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1549
Practice Address - Country:US
Practice Address - Phone:860-484-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT078695847106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician