Provider Demographics
NPI:1558070755
Name:ADAMS, MEGAN (ED S)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ED S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10423 RALEIGH RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-4202
Mailing Address - Country:US
Mailing Address - Phone:651-329-2050
Mailing Address - Fax:
Practice Address - Street 1:10423 RALEIGH RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-4202
Practice Address - Country:US
Practice Address - Phone:651-329-2050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool