Provider Demographics
NPI:1346578556
Name:WORTHINGTON, MEGAN MALETTE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:MALETTE
Last Name:WORTHINGTON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6350 COONPATH RD NE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-9334
Mailing Address - Country:US
Mailing Address - Phone:740-536-7233
Mailing Address - Fax:
Practice Address - Street 1:6350 COONPATH RD NE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-9334
Practice Address - Country:US
Practice Address - Phone:740-536-7233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-28
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 6317235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist