Provider Demographics
NPI:1518316074
Name:MURPHY, MEGHANN (TLLP)
Entity Type:Individual
Prefix:
First Name:MEGHANN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:TLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28454 N CLEMENTS CIR
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3102
Mailing Address - Country:US
Mailing Address - Phone:734-788-7634
Mailing Address - Fax:
Practice Address - Street 1:315 N CENTER ST
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-1277
Practice Address - Country:US
Practice Address - Phone:734-788-7634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
MI6301016709103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other