Provider Demographics
NPI:1962751347
Name:MCGHAN, ANNA CHRISTINE (BCBA)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:CHRISTINE
Last Name:MCGHAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:CHRISTINE
Other - Last Name:PETTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4910 AIRPORT AVE
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-5759
Mailing Address - Country:US
Mailing Address - Phone:281-239-1477
Mailing Address - Fax:281-239-7683
Practice Address - Street 1:4910 AIRPORT AVE
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5759
Practice Address - Country:US
Practice Address - Phone:281-239-1477
Practice Address - Fax:281-239-7683
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-13-12748103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst