Provider Demographics
NPI:1093144867
Name:GUERIN, MEGAN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:GUERIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CARRIAGE HL
Mailing Address - Street 2:
Mailing Address - City:NORTH YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04097-6069
Mailing Address - Country:US
Mailing Address - Phone:617-838-3462
Mailing Address - Fax:
Practice Address - Street 1:408 GRAY RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-4290
Practice Address - Country:US
Practice Address - Phone:617-838-3462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP-9095-SL235Z00000X
MESP2779235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist