Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | BH002874 | PA |
N | 174N00000X | Lactation Consultant | 280708 | PA |
NPI | 1366812455 |
---|---|
Provider Name | Megan Fettrow |
First Address | East Berlin, PA 17316-9311 |
Second Address | York, PA 17403-3717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2015 |
Last Update Date | 23/10/2018 |