Provider Demographics
NPI:1669901732
Name:GOLD, MEGAN SHELBY (BCBA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:SHELBY
Last Name:GOLD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:SHELBY
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6402 APOLLO DR APT D
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2922
Mailing Address - Country:US
Mailing Address - Phone:919-610-2340
Mailing Address - Fax:
Practice Address - Street 1:6402 APOLLO DR APT D
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2922
Practice Address - Country:US
Practice Address - Phone:919-610-2340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst