Provider Demographics
NPI:1093179327
Name:BLAND, MEGAN (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:BLAND
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 1:301 SWANN TRL
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-6504
Mailing Address - Country:US
Mailing Address - Phone:252-902-7636
Mailing Address - Fax:
Practice Address - Street 1:301 SWANN TRL
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-6504
Practice Address - Country:US
Practice Address - Phone:252-902-7636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6108235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist