Provider Demographics
NPI:1104397546
Name:MEADOWS, ELISABETH MEGAN
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:MEGAN
Last Name:MEADOWS
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 1:4457 HIGHLAND GATE PKWY
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-2961
Mailing Address - Country:US
Mailing Address - Phone:912-293-0813
Mailing Address - Fax:
Practice Address - Street 1:6075 BARFIELD RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4402
Practice Address - Country:US
Practice Address - Phone:404-884-3834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-11
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst