Provider Demographics
NPI:1245761469
Name:HOBSON, MEGAN (SLP CCC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HOBSON
Suffix:
Gender:F
Credentials:SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961 SELMA ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-7579
Mailing Address - Country:US
Mailing Address - Phone:334-796-0330
Mailing Address - Fax:
Practice Address - Street 1:2961 SELMA ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-7579
Practice Address - Country:US
Practice Address - Phone:334-796-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA15150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist