Provider Demographics
NPI:1083489595
Name:WROBLEWSKI, MEGAN L (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:WROBLEWSKI
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 1:8435 FORESTVIEW LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4698
Mailing Address - Country:US
Mailing Address - Phone:952-250-6289
Mailing Address - Fax:
Practice Address - Street 1:3021 HARBOR LN N STE 120
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-5141
Practice Address - Country:US
Practice Address - Phone:763-551-3652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN528479235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist