Basic Information
| Provider Information | |||||||||
| NPI: | 1487909677 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDONALD | ||||||||
| FirstName: | MEGHAN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | BS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5138 GLENFIELD DR | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486385567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897142457 | ||||||||
| FaxNumber: | 9897815422 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 S WASHINGTON RD | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486014958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897551072 | ||||||||
| FaxNumber: | 9897551401 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2012 | ||||||||
| LastUpdateDate: | 08/01/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.