Provider Demographics
NPI:1245397553
Name:O'MALLEY, MEGAN MCDONOUGH (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:MCDONOUGH
Last Name:O'MALLEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MCDONOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:3211 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-5427
Mailing Address - Country:US
Mailing Address - Phone:512-533-9313
Mailing Address - Fax:512-533-9317
Practice Address - Street 1:3211 HANCOCK DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-5427
Practice Address - Country:US
Practice Address - Phone:512-533-9313
Practice Address - Fax:512-533-9317
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101488235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist