Provider Demographics
NPI:1770017329
Name:MOIR, MEGAN L
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:L
Last Name:MOIR
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 1:312A WILSON PIKE CIR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2743
Mailing Address - Country:US
Mailing Address - Phone:615-499-5453
Mailing Address - Fax:
Practice Address - Street 1:312A WILSON PIKE CIR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2743
Practice Address - Country:US
Practice Address - Phone:615-499-5453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional