| Doctor Name: | MEAGHAN IANDOLO |
| NPI Number: | 1417314956 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | C.1600053 |
| Business Practice Address: | 3500 Kettering Blvd Moraine, OH - 454392015 |
| Business Phone Number: | 2012592542 |
| Business Fax Number: | |
| Mailing Address: | 4070 Stonehaven Rd, KETTERING |
| State: | OH |
| Postal Code: | 454291761 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/27/2016 |
| NPI Last Update Date: | 01/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | C.1600053 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |