Provider Demographics
NPI:1447304829
Name:WEATHERFORD, MEGAN LEIGH (NMT, MT-BC)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:LEIGH
Last Name:WEATHERFORD
Suffix:
Gender:F
Credentials:NMT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 WOODLAND LN
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-8742
Mailing Address - Country:US
Mailing Address - Phone:770-572-2889
Mailing Address - Fax:678-560-6691
Practice Address - Street 1:1000 JOHNSON FERRY RD
Practice Address - Street 2:SUITE B-145
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2114
Practice Address - Country:US
Practice Address - Phone:678-560-6560
Practice Address - Fax:678-560-6691
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA07178225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist