Provider Demographics
NPI:1306388582
Name:BYARS, MEGAN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:BYARS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:VANDE BURGT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4108 BEGONIA LOOP
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-4103
Mailing Address - Country:US
Mailing Address - Phone:920-284-5303
Mailing Address - Fax:
Practice Address - Street 1:4108 BEGONIA LOOP
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-4103
Practice Address - Country:US
Practice Address - Phone:920-284-5303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-05
Last Update Date:2016-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health