Provider Demographics
NPI:1154469583
Name:NALLS, MEAGAN LYNETTE
Entity Type:Individual
Prefix:MISS
First Name:MEAGAN
Middle Name:LYNETTE
Last Name:NALLS
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 1:110 16TH ST
Mailing Address - Street 2:APT. # 2208
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1473
Mailing Address - Country:US
Mailing Address - Phone:615-479-1483
Mailing Address - Fax:
Practice Address - Street 1:110 16TH ST
Practice Address - Street 2:APT. # 2208
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1473
Practice Address - Country:US
Practice Address - Phone:615-479-1483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health