Individual
DR. MEGAN ELIZABETH DIQUATTRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY,D
Contact information
Practice address
16 EASTBROOK BND, UNIT 102B, PEACHTREE CITY, GA 30269-1568
(770) 629-6517
Mailing address
16 EASTBROOK BND, UNIT 102B, PEACHTREE CITY, GA 30269-1568
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY 003885
GA
103T00000X
Psychologist
PSY 003885
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-4749035
TAX IDENTIFICATION NUMBER
—
Enumeration date
05/03/2016
Last updated
05/03/2016
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