Provider Demographics
NPI:1992516959
Name:NUDELL, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:NUDELL
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 1:1321 S LINDEN RD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532
Mailing Address - Country:US
Mailing Address - Phone:248-221-2573
Mailing Address - Fax:
Practice Address - Street 1:1321 S LINDEN RD
Practice Address - Street 2:SUITE B
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3440
Practice Address - Country:US
Practice Address - Phone:248-221-2573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician