Provider Demographics
NPI:1780231902
Name:BARTHLE-HERRERA, MEGAN ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ANNE
Last Name:BARTHLE-HERRERA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:ANNE
Other - Last Name:BARTHLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:4197 NW 86TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-9278
Mailing Address - Country:US
Mailing Address - Phone:352-265-4357
Mailing Address - Fax:352-627-4161
Practice Address - Street 1:4197 NW 86TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-9278
Practice Address - Country:US
Practice Address - Phone:352-265-4357
Practice Address - Fax:352-627-4161
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10538103TB0200X, 103TC1900X, 103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent