Provider Demographics
NPI:1760659049
Name:PERRY, MEGAN MCCARTNEY (PLPC)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:MCCARTNEY
Last Name:PERRY
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9137 OLD BONHOMME RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-4417
Mailing Address - Country:US
Mailing Address - Phone:314-997-7002
Mailing Address - Fax:
Practice Address - Street 1:9137 OLD BONHOMME RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-4417
Practice Address - Country:US
Practice Address - Phone:314-997-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008011251390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program