Provider Demographics
NPI:1588248157
Name:HOWARD, MARY MEGAN (LCAT, ATR-BC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MEGAN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LCAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 METROPOLITAN AVE APT 19
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-4051
Mailing Address - Country:US
Mailing Address - Phone:704-449-3388
Mailing Address - Fax:
Practice Address - Street 1:222 METROPOLITAN AVE APT 19
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-4051
Practice Address - Country:US
Practice Address - Phone:704-449-3388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002331221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist