Provider Demographics
NPI:1245116128
Name:MEAGHER, ANGELOU GALE PEREZ
Entity type:Individual
Prefix:
First Name:ANGELOU GALE
Middle Name:PEREZ
Last Name:MEAGHER
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 1:3342 AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-8461
Mailing Address - Country:US
Mailing Address - Phone:858-335-5120
Mailing Address - Fax:
Practice Address - Street 1:351 WAGONER DR STE 325
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4674
Practice Address - Country:US
Practice Address - Phone:910-491-0061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician