Provider Demographics
NPI:1497926091
Name:THOMPSON, MEGAN MICHIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:MICHIE
Last Name:THOMPSON
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 1:6236 PROVIDENCE CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-3697
Mailing Address - Country:US
Mailing Address - Phone:404-825-1000
Mailing Address - Fax:
Practice Address - Street 1:6236 PROVIDENCE CLUB DR
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-3697
Practice Address - Country:US
Practice Address - Phone:404-825-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-22
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3219235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist