Provider Demographics
NPI:1639402787
Name:MURRAY, MEGAN GRAY (PHD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:GRAY
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 HANDASYDE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2718
Mailing Address - Country:US
Mailing Address - Phone:513-533-3604
Mailing Address - Fax:
Practice Address - Street 1:5134 CEDAR VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3717
Practice Address - Country:US
Practice Address - Phone:513-229-7900
Practice Address - Fax:513-229-0202
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5461103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical