Provider Demographics
NPI:1114332707
Name:HOSACK, MEGAN
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:
Last Name:HOSACK
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 1:7326 STATE ROUTE 19 UNIT 1709
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-9300
Mailing Address - Country:US
Mailing Address - Phone:419-961-5036
Mailing Address - Fax:
Practice Address - Street 1:7326 STATE ROUTE 19 UNIT 1709
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-9300
Practice Address - Country:US
Practice Address - Phone:419-961-5036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst