Provider Demographics
NPI:1871990093
Name:THOMPSON, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:THOMPSON
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 1:9000 COLLEGE STA
Mailing Address - Street 2:BOWDOIN COLLEGE
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-8490
Mailing Address - Country:US
Mailing Address - Phone:207-725-3942
Mailing Address - Fax:
Practice Address - Street 1:9000 COLLEGE STA
Practice Address - Street 2:BOWDOIN COLLEGE
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-8490
Practice Address - Country:US
Practice Address - Phone:207-725-3942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAT2462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer