Provider Demographics
NPI:1770056574
Name:MCDOWELL-DELGADO, MEGAN (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MCDOWELL-DELGADO
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:RENEE
Other - Last Name:MCDOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, QBHP
Mailing Address - Street 1:666 E MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49032-9803
Mailing Address - Country:US
Mailing Address - Phone:269-241-2700
Mailing Address - Fax:
Practice Address - Street 1:666 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MI
Practice Address - Zip Code:49032-9803
Practice Address - Country:US
Practice Address - Phone:269-241-2700
Practice Address - Fax:269-241-2701
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1770056574103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1770056574Medicaid