Provider Demographics
NPI:1043053135
Name:OLIVER, MEGHAN
Entity type:Individual
Prefix:MISS
First Name:MEGHAN
Middle Name:
Last Name:OLIVER
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 1:57 REGIONAL DR STE 7
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-8518
Mailing Address - Country:US
Mailing Address - Phone:603-224-7630
Mailing Address - Fax:603-410-1105
Practice Address - Street 1:57 REGIONAL DR STE 7
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-8518
Practice Address - Country:US
Practice Address - Phone:603-224-7630
Practice Address - Fax:603-410-1105
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-24-73662103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst