Provider Demographics
NPI:1508400854
Name:PECK, MEAGAN FRIEL (MS, BCBA, LBS)
Entity Type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:FRIEL
Last Name:PECK
Suffix:
Gender:F
Credentials:MS, BCBA, LBS
Other - Prefix:MISS
Other - First Name:MEAGAN
Other - Middle Name:LYNNE
Other - Last Name:FRIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:998 OLD EAGLE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:998 OLD EAGLE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1805
Practice Address - Country:US
Practice Address - Phone:267-279-3680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH004417103K00000X
PA1-17-26327103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst