Provider Demographics
NPI:1992380794
Name:GAZAWAY, MEGHAN ROSE (MED, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ROSE
Last Name:GAZAWAY
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:ROSE
Other - Last Name:CONTRERAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5409 BARKRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-4320
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2020 E HEBRON PKWY STE 110
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1609
Practice Address - Country:US
Practice Address - Phone:832-260-3053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst