Provider Demographics
NPI:1093399396
Name:ROCKWELL-ASHTON, MEGHAN A
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:A
Last Name:ROCKWELL-ASHTON
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 1:500 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46802-1406
Mailing Address - Country:US
Mailing Address - Phone:260-421-5000
Mailing Address - Fax:260-421-5003
Practice Address - Street 1:500 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-1406
Practice Address - Country:US
Practice Address - Phone:260-421-5000
Practice Address - Fax:260-421-5003
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008045A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical