Provider Demographics
NPI:1598399222
Name:DEVINE, MEGHAN (PSYD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:
Last Name:DEVINE
Suffix:
Gender:F
Credentials:PSYD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 S STATE ST BLDG A
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1945
Mailing Address - Country:US
Mailing Address - Phone:267-685-6210
Mailing Address - Fax:
Practice Address - Street 1:444 S STATE ST BLDG A
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1945
Practice Address - Country:US
Practice Address - Phone:267-755-9333
Practice Address - Fax:215-550-6966
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1063782001OtherSUPERVISOR