Provider Demographics
NPI:1114409745
Name:STADNIK, MEGAN NICOLE (MS-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:STADNIK
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:NICOLE
Other - Last Name:BEIERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS-SLP
Mailing Address - Street 1:55 RESER RD
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-8871
Mailing Address - Country:US
Mailing Address - Phone:509-520-3088
Mailing Address - Fax:
Practice Address - Street 1:55 RESER RD
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-8871
Practice Address - Country:US
Practice Address - Phone:509-520-3088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist