Provider Demographics
NPI:1053632810
Name:BOUNDS, MEGAN LOGAN (MS/CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:LOGAN
Last Name:BOUNDS
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17540 JONES LN
Mailing Address - Street 2:
Mailing Address - City:SAUCIER
Mailing Address - State:MS
Mailing Address - Zip Code:39574-9181
Mailing Address - Country:US
Mailing Address - Phone:601-479-3522
Mailing Address - Fax:
Practice Address - Street 1:12303 HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-2780
Practice Address - Country:US
Practice Address - Phone:228-832-6221
Practice Address - Fax:228-832-4033
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3209235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist