Provider Demographics
NPI:1770010183
Name:KANTROWITZ, MEAGHAN K (BCBA)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:K
Last Name:KANTROWITZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:MEAGHAN
Other - Middle Name:E
Other - Last Name:KANALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:6516 BROADWAY ST STE 112
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-7879
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6516 BROADWAY ST STE 112
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-7879
Practice Address - Country:US
Practice Address - Phone:281-258-4447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-25781103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst