Provider Demographics
NPI:1811352016
Name:PIREHPOUR, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:PIREHPOUR
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 1:25622 N SINGBUSH LOOP
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85083-2457
Mailing Address - Country:US
Mailing Address - Phone:480-246-2100
Mailing Address - Fax:
Practice Address - Street 1:25622 N SINGBUSH LOOP
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85083-2457
Practice Address - Country:US
Practice Address - Phone:480-246-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4474081385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child