Provider Demographics
NPI:1467214056
Name:GOEGLEIN, MEGHAN
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:GOEGLEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47910 STATE ROUTE 248
Mailing Address - Street 2:
Mailing Address - City:LONG BOTTOM
Mailing Address - State:OH
Mailing Address - Zip Code:45743-9011
Mailing Address - Country:US
Mailing Address - Phone:740-818-6854
Mailing Address - Fax:
Practice Address - Street 1:41765 POMEROY PIKE
Practice Address - Street 2:
Practice Address - City:POMEROY
Practice Address - State:OH
Practice Address - Zip Code:45769-9411
Practice Address - Country:US
Practice Address - Phone:740-992-2153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.15354235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist