Provider Demographics
NPI:1053474726
Name:SCRANTON, MEGAN JENNIFER (SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JENNIFER
Last Name:SCRANTON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 CHELSEA LOOP
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-1728
Mailing Address - Country:US
Mailing Address - Phone:717-464-2180
Mailing Address - Fax:
Practice Address - Street 1:2215 DUTCH GOLD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1940
Practice Address - Country:US
Practice Address - Phone:717-569-8972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005658L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010022270001OtherPA MEDICAL ASSISTANCE