Provider Demographics
NPI:1013696400
Name:MURPHY, MARY MEGHAN
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MEGHAN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MEGHAN
Other - Last Name:HEALY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17453 ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1201
Mailing Address - Country:US
Mailing Address - Phone:574-383-0575
Mailing Address - Fax:
Practice Address - Street 1:17453 ARBOR DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1201
Practice Address - Country:US
Practice Address - Phone:574-383-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist