Provider Demographics
NPI:1326682204
Name:BOYEA, MEGAN LYN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYN
Last Name:BOYEA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-1818
Mailing Address - Country:US
Mailing Address - Phone:315-261-5460
Mailing Address - Fax:315-261-6460
Practice Address - Street 1:50 LEROY ST
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-1786
Practice Address - Country:US
Practice Address - Phone:315-261-6460
Practice Address - Fax:315-261-6460
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP100891235Z00000X
NY030340-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist