Provider Demographics
NPI:1114067162
Name:COULTER, MEGHAN O'NEIL
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:O'NEIL
Last Name:COULTER
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 1:11940 ALPHARETTA HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2003
Mailing Address - Country:US
Mailing Address - Phone:770-754-0085
Mailing Address - Fax:770-754-9288
Practice Address - Street 1:11940 ALPHARETTA HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-2003
Practice Address - Country:US
Practice Address - Phone:770-754-0085
Practice Address - Fax:770-754-9288
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007188235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist