Provider Demographics
NPI:1134857659
Name:ANNIS, MEAGHAN MARIA
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:MARIA
Last Name:ANNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NH
Mailing Address - Zip Code:03833-6426
Mailing Address - Country:US
Mailing Address - Phone:508-562-9360
Mailing Address - Fax:
Practice Address - Street 1:42 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NH
Practice Address - Zip Code:03833-6426
Practice Address - Country:US
Practice Address - Phone:508-562-9360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician