Provider Demographics
NPI:1205000403
Name:MCPHERSON, MEAGAN RAE (PSYD)
Entity Type:Individual
Prefix:MS
First Name:MEAGAN
Middle Name:RAE
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 E 7TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-2551
Mailing Address - Country:US
Mailing Address - Phone:559-289-4310
Mailing Address - Fax:
Practice Address - Street 1:10515 W MARKHAM ST STE E3
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2139
Practice Address - Country:US
Practice Address - Phone:501-251-1857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR11-10AP-PL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical