Individual
MEGAN COMMEDO MORAVIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7604 FAIRHAVEN RD, BROWNS SUMMIT, NC 27214-9643
(336) 554-3486
Mailing address
3428 N CHURCH ST, GREENSBORO, NC 27405-3254
(336) 542-0581
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL-041-1142
NC
Other
Enumeration date
11/04/2017
Last updated
11/04/2017
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