Individual
MEGAN MACKOWIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1316 W DRAGOON TRL, MISHAWAKA, IN 46544-4713
(574) 855-4292
Mailing address
1316 W DRAGOON TRL, MISHAWAKA, IN 46544-4713
(574) 855-4292
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48080
IN
Other
Enumeration date
03/03/2021
Last updated
03/03/2021
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