Provider Demographics
NPI:1265002182
Name:SCOTT, MEGAN (MS)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 FLAMINGO ST
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-2383
Mailing Address - Country:US
Mailing Address - Phone:626-327-1526
Mailing Address - Fax:
Practice Address - Street 1:529 E LIVE OAK AVE STE E
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5600
Practice Address - Country:US
Practice Address - Phone:626-538-2751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14715235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist