Provider Demographics
NPI:1336652296
Name:HOFFMAN, MEGAN MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:HOFFMAN
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 1:8796 ROUTE 219
Mailing Address - Street 2:
Mailing Address - City:BROCKWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15824-6010
Mailing Address - Country:US
Mailing Address - Phone:814-265-7852
Mailing Address - Fax:
Practice Address - Street 1:8796 ROUTE 219
Practice Address - Street 2:
Practice Address - City:BROCKWAY
Practice Address - State:PA
Practice Address - Zip Code:15824-6010
Practice Address - Country:US
Practice Address - Phone:814-265-7852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013087235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist