Provider Demographics
NPI:1427361021
Name:BULLEN, MEGAN AJA (MA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:AJA
Last Name:BULLEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1282 JOSEPHINE CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-3434
Mailing Address - Country:US
Mailing Address - Phone:419-614-0729
Mailing Address - Fax:
Practice Address - Street 1:2465 COLLINGWOOD BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43620-1153
Practice Address - Country:US
Practice Address - Phone:419-241-8827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor