Provider Demographics
NPI:1922584820
Name:MUSIC, MEGAN NICOLE
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:MUSIC
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 1:204 S CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31503-2612
Mailing Address - Country:US
Mailing Address - Phone:912-282-0992
Mailing Address - Fax:
Practice Address - Street 1:204 S CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31503-2612
Practice Address - Country:US
Practice Address - Phone:912-282-0992
Practice Address - Fax:912-285-8817
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5299101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health