Provider Demographics
NPI:1033647458
Name:GIVENS, MEGAN (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:GIVENS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 GOODMAN RD E STE 1
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-9556
Mailing Address - Country:US
Mailing Address - Phone:662-782-5330
Mailing Address - Fax:662-782-5329
Practice Address - Street 1:1630 GOODMAN RD E STE 1
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-9556
Practice Address - Country:US
Practice Address - Phone:662-782-5330
Practice Address - Fax:662-782-5329
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS4315235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist