Provider Demographics
NPI:1285230409
Name:RILEY, MEGHAN ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ANN
Last Name:RILEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 941
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28512-0941
Mailing Address - Country:US
Mailing Address - Phone:724-858-9124
Mailing Address - Fax:
Practice Address - Street 1:2994 OLD AIRPORT RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-8738
Practice Address - Country:US
Practice Address - Phone:252-672-8680
Practice Address - Fax:252-638-6989
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13187235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty