Provider Demographics
NPI:1417520578
Name:WOLF, MEGAN REED (AUD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:REED
Last Name:WOLF
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:REED
Other - Last Name:LOSINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:6341 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4946
Mailing Address - Country:US
Mailing Address - Phone:763-586-5844
Mailing Address - Fax:
Practice Address - Street 1:6341 UNIVERSITY AVE NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-4946
Practice Address - Country:US
Practice Address - Phone:763-586-5844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist