Provider Demographics
NPI:1487881769
Name:MCDERMOTT, MEGHAN (BA)
Entity type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 COLE ST
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-2601
Mailing Address - Country:US
Mailing Address - Phone:401-575-8868
Mailing Address - Fax:508-679-8590
Practice Address - Street 1:29 COLE ST
Practice Address - Street 2:APARTMENT 2
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-2601
Practice Address - Country:US
Practice Address - Phone:401-575-8868
Practice Address - Fax:508-679-8590
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist