Provider Demographics
NPI:1528412756
Name:THOMAS, MEGAN ALLISON (MSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ALLISON
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 E WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2412
Mailing Address - Country:US
Mailing Address - Phone:858-442-0546
Mailing Address - Fax:
Practice Address - Street 1:1044 E WOOD AVE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-2412
Practice Address - Country:US
Practice Address - Phone:858-442-0546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker