Provider Demographics
NPI:1568879799
Name:MAJETSKY, MEGAN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MAJETSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MAJETSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSC
Mailing Address - Street 1:PO BOX 136
Mailing Address - Street 2:
Mailing Address - City:QUAKAKE
Mailing Address - State:PA
Mailing Address - Zip Code:18245-0136
Mailing Address - Country:US
Mailing Address - Phone:570-956-5642
Mailing Address - Fax:
Practice Address - Street 1:136 W MAIN ST
Practice Address - Street 2:
Practice Address - City:QUAKAKE
Practice Address - State:PA
Practice Address - Zip Code:18245-0136
Practice Address - Country:US
Practice Address - Phone:570-956-5642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001536103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst