Provider Demographics
NPI:1760068415
Name:MCCANN, MEGAN J
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:J
Last Name:MCCANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MAD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:NH
Mailing Address - Zip Code:03285-6408
Mailing Address - Country:US
Mailing Address - Phone:603-782-1451
Mailing Address - Fax:
Practice Address - Street 1:60 MAD RIVER RD
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:NH
Practice Address - Zip Code:03285-6408
Practice Address - Country:US
Practice Address - Phone:603-782-1451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health