| Doctor Name: | MRS. KELLY STANGL MEDDAUGH |
| NPI Number: | 1265573596 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CW |
| License Number: | CW013798 |
| Business Practice Address: | 550 Pinetown Rd Suite 210 Ft Washington, PA - 190342605 |
| Business Phone Number: | 2156430200 |
| Business Fax Number: | 2156439844 |
| Mailing Address: | 830 Chestnut St, Suite #2 ROYERSFORD |
| State: | PA |
| Postal Code: | 194682160 |
| Phone Number: | 6109482200 |
| Fax Number: | 6109482203 |
| NPI Enumeration Date: | 02/09/2007 |
| NPI Last Update Date: | 05/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CW013798 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |