Provider Demographics
NPI:1538664370
Name:PAWSON, MEGAN (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:PAWSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-4309
Mailing Address - Country:US
Mailing Address - Phone:517-265-0950
Mailing Address - Fax:
Practice Address - Street 1:777 KIMOLE LN STE 110
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1400
Practice Address - Country:US
Practice Address - Phone:517-265-0950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-17-30011103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst