Provider Demographics
NPI:1619374931
Name:THRELOFF, MEGAN ARTHUR (EDS, NCSP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ARTHUR
Last Name:THRELOFF
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:ARTHUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDS, NCSP
Mailing Address - Street 1:927 SOUTH ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-6014
Mailing Address - Country:US
Mailing Address - Phone:740-964-3456
Mailing Address - Fax:
Practice Address - Street 1:927 SOUTH ST UNIT A
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-6014
Practice Address - Country:US
Practice Address - Phone:740-964-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3107966103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool