Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003118001 |
---|---|
Provider Name | Megan Renee Eddy |
First Address | Norwich, CT 06360-2708 |
Second Address | Norwich, CT 06360-2708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2010 |
Last Update Date | 20/02/2017 |