Provider Demographics
NPI:1376676262
Name:SAFKO, MEGHAN M
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:M
Last Name:SAFKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:M
Other - Last Name:SAFKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:2728 E PURDUE AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-4720
Mailing Address - Country:US
Mailing Address - Phone:303-204-2473
Mailing Address - Fax:602-254-5178
Practice Address - Street 1:4530 E SHEA BLVD STE 180
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6042
Practice Address - Country:US
Practice Address - Phone:602-264-4834
Practice Address - Fax:602-254-5178
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD496231H00000X
AZDA13709231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAUD496OtherAUDIOLOGY LIC