Provider Demographics
NPI:1194200899
Name:WANG, MEGAN YI-LIN (SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:YI-LIN
Last Name:WANG
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 21ST ST UNIT 103
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-1871
Mailing Address - Country:US
Mailing Address - Phone:612-388-1268
Mailing Address - Fax:
Practice Address - Street 1:655 S 8TH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4624
Practice Address - Country:US
Practice Address - Phone:409-784-5435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113663235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist