Provider Demographics
NPI:1831694876
Name:PRYOR, MEAGAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:
Last Name:PRYOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N ABINGTON RD
Mailing Address - Street 2:
Mailing Address - City:CLARKS GREEN
Mailing Address - State:PA
Mailing Address - Zip Code:18411-2541
Mailing Address - Country:US
Mailing Address - Phone:570-586-2966
Mailing Address - Fax:
Practice Address - Street 1:120 N ABINGTON RD
Practice Address - Street 2:
Practice Address - City:CLARKS GREEN
Practice Address - State:PA
Practice Address - Zip Code:18411-2541
Practice Address - Country:US
Practice Address - Phone:570-586-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018465103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical