Provider Demographics
NPI:1932645702
Name:DIDONATO, MEGAN S (ATC LAT)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:S
Last Name:DIDONATO
Suffix:
Gender:F
Credentials:ATC LAT
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:S
Other - Last Name:ONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC LAT
Mailing Address - Street 1:6767 LAKE WOODLANDS DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2566
Mailing Address - Country:US
Mailing Address - Phone:281-364-1122
Mailing Address - Fax:281-210-2446
Practice Address - Street 1:6767 LAKE WOODLANDS DR
Practice Address - Street 2:SUITE F
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2566
Practice Address - Country:US
Practice Address - Phone:281-364-1122
Practice Address - Fax:281-210-2446
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT43572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer