Provider Demographics
NPI:1912400417
Name:SAUDER, MEGHAN FERGUSON
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:FERGUSON
Last Name:SAUDER
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 1:167 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01944-1419
Mailing Address - Country:US
Mailing Address - Phone:978-236-3134
Mailing Address - Fax:
Practice Address - Street 1:167 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01944-1419
Practice Address - Country:US
Practice Address - Phone:978-236-3134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1118891041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool