Provider Demographics
NPI:1407975071
Name:HANSON, MEGAN MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:MARIE
Last Name:HANSON
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 1:614 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IL
Mailing Address - Zip Code:61727-1449
Mailing Address - Country:US
Mailing Address - Phone:219-513-8311
Mailing Address - Fax:708-479-2112
Practice Address - Street 1:614 N MONROE ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IL
Practice Address - Zip Code:61727-1449
Practice Address - Country:US
Practice Address - Phone:219-513-8311
Practice Address - Fax:708-479-2112
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008255235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist