Provider Demographics
NPI:1932494960
Name:PAUL, MEGAN SARAH (MED)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:SARAH
Last Name:PAUL
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 OLD WALNUT BR
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-8661
Mailing Address - Country:US
Mailing Address - Phone:706-267-4448
Mailing Address - Fax:
Practice Address - Street 1:1727 WRIGHTSBORO RD
Practice Address - Street 2:SUITE B
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-4074
Practice Address - Country:US
Practice Address - Phone:706-736-8170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional