Provider Demographics
NPI:1366678880
Name:CUMMINS, MEGAN NICOLE (MT-BC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8502 EASTWOOD TER
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236-2672
Mailing Address - Country:US
Mailing Address - Phone:804-244-0193
Mailing Address - Fax:
Practice Address - Street 1:8502 EASTWOOD TER
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23236-2672
Practice Address - Country:US
Practice Address - Phone:804-244-0193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
08495225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist