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Individual

MEGHAN STREET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ALC

Contact information

Practice address
605A MEDICAL CENTER PKWY, BOAZ, AL 35957-5937
(256) 239-5662
Mailing address
PO BOX 1162, JACKSONVILLE, AL 36265-5162
(256) 239-5662

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2716A
AL

Other

Enumeration date
10/15/2018
Last updated
10/15/2018
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