Provider Demographics
NPI:1467957985
Name:PHADKE, MEGHAN DEEPAK (MT-BC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:DEEPAK
Last Name:PHADKE
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 NW CASABLANCA LN UNIT 215
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-0028
Mailing Address - Country:US
Mailing Address - Phone:913-634-8664
Mailing Address - Fax:
Practice Address - Street 1:3410 NW CASABLANCA LN UNIT 215
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-0028
Practice Address - Country:US
Practice Address - Phone:913-634-8664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist