| Doctor Name: | MRS. MEGHAN LEA SHADICK |
| NPI Number: | 1285891895 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CRC, LPC-IT |
| License Number: | |
| Business Practice Address: | 18266 County Highway Q Bloomer, WI - 547243826 |
| Business Phone Number: | 7159330297 |
| Business Fax Number: | |
| Mailing Address: | 18266 County Highway Q, BLOOMER |
| State: | WI |
| Postal Code: | 547243826 |
| Phone Number: | 7159330297 |
| Fax Number: | |
| NPI Enumeration Date: | 05/21/2008 |
| NPI Last Update Date: | 01/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |