Provider Demographics
NPI:1336819820
Name:EVERHART, MAEGAN ELIZABETH
Entity Type:Individual
Prefix:
First Name:MAEGAN
Middle Name:ELIZABETH
Last Name:EVERHART
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 1:1573 CRESTDALE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKHILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732
Mailing Address - Country:US
Mailing Address - Phone:803-417-8662
Mailing Address - Fax:
Practice Address - Street 1:1573 CRESTDALE RD
Practice Address - Street 2:
Practice Address - City:ROCKHILL
Practice Address - State:SC
Practice Address - Zip Code:29732
Practice Address - Country:US
Practice Address - Phone:803-417-8662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician