Provider Demographics
NPI:1518529890
Name:JARVIS, MEGHAN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:JARVIS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:DOWDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20418 NEW KENTUCKY VLG
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-8776
Mailing Address - Country:US
Mailing Address - Phone:808-639-3057
Mailing Address - Fax:
Practice Address - Street 1:20418 NEW KENTUCKY VLG
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-8776
Practice Address - Country:US
Practice Address - Phone:281-940-5717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115592235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14300542OtherASHA