Provider Demographics
NPI:1376806117
Name:HABERKORN, MEGHAN CATHERINE (MS ED)
Entity Type:Individual
Prefix:MISS
First Name:MEGHAN
Middle Name:CATHERINE
Last Name:HABERKORN
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:54 MISTY POND CIR
Mailing Address - Street 2:APARTMENT 12
Mailing Address - City:MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11955-1134
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:54 MISTY POND CIRCLE
Practice Address - Street 2:APARTMENT 12
Practice Address - City:MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11955-1134
Practice Address - Country:US
Practice Address - Phone:631-921-1194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst