Provider Demographics
NPI:1952657660
Name:GAYLORD, MEGAN KATHLEEN (MS)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:KATHLEEN
Last Name:GAYLORD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24 WEATHERFORD SQ
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2202
Mailing Address - Country:US
Mailing Address - Phone:731-984-6201
Mailing Address - Fax:731-984-6209
Practice Address - Street 1:24 WEATHERFOD SQ
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305
Practice Address - Country:US
Practice Address - Phone:731-984-6201
Practice Address - Fax:731-984-6209
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health