Provider Demographics
NPI:1578718078
Name:DEAN, MEGAN ANN (MSCCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ANN
Last Name:DEAN
Suffix:
Gender:F
Credentials:MSCCC/SLP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ANN
Other - Last Name:EITAPENCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:169 RIVERSIDE DR
Mailing Address - Street 2:LOURDES HOSPITAL
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4246
Mailing Address - Country:US
Mailing Address - Phone:607-798-5255
Mailing Address - Fax:607-798-5192
Practice Address - Street 1:169 RIVERSIDE DR
Practice Address - Street 2:LOURDES HOSPITAL
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4246
Practice Address - Country:US
Practice Address - Phone:607-798-5255
Practice Address - Fax:607-798-5192
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016334-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist