Provider Demographics
NPI:1699423392
Name:GUENTHER, MEAGAN MARIE (LEP)
Entity type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:MARIE
Last Name:GUENTHER
Suffix:
Gender:F
Credentials:LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 TOWNSGATE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-3034
Mailing Address - Country:US
Mailing Address - Phone:424-334-9874
Mailing Address - Fax:
Practice Address - Street 1:2801 TOWNSGATE RD STE 102
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-3034
Practice Address - Country:US
Practice Address - Phone:424-334-9874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-13
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4183103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist