Provider Demographics
NPI:1265784466
Name:MARSH, MEGAN CAMPBELL (PHD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:CAMPBELL
Last Name:MARSH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:225 OAKLAND RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2866
Mailing Address - Country:US
Mailing Address - Phone:860-644-8877
Mailing Address - Fax:860-644-8801
Practice Address - Street 1:225 OAKLAND RD
Practice Address - Street 2:SUITE 302
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2866
Practice Address - Country:US
Practice Address - Phone:860-644-8877
Practice Address - Fax:860-644-8801
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3234103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist