Provider Demographics
NPI:1487016986
Name:MOBLEY, MEGAN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:COADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:3478 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-7733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13300 HICKMAN RD
Practice Address - Street 2:STE 110
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8616
Practice Address - Country:US
Practice Address - Phone:515-987-8835
Practice Address - Fax:515-987-4637
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-23
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002377235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist