Provider Demographics
NPI:1962986075
Name:MCNAULL, MEGHAN ELLYN
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELLYN
Last Name:MCNAULL
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 1:619 DOLLEY MADISON RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-4205
Mailing Address - Country:US
Mailing Address - Phone:813-838-4732
Mailing Address - Fax:813-337-0937
Practice Address - Street 1:619 DOLLEY MADISON RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4205
Practice Address - Country:US
Practice Address - Phone:813-838-4732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist