Provider Demographics
NPI:1548605710
Name:DAVIS, MEGAN LEE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:3002 N MERCER STREET EXT
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1627
Mailing Address - Country:US
Mailing Address - Phone:301-512-4129
Mailing Address - Fax:
Practice Address - Street 1:26 PITTSBURGH CIR
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-2136
Practice Address - Country:US
Practice Address - Phone:301-512-4129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2020-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013184235Z00000X
NC10385235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist