Provider Demographics
NPI:1598143794
Name:KELESHIAN, MEGAN (MA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:KELESHIAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27250 HIGHLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143
Mailing Address - Country:US
Mailing Address - Phone:440-539-2353
Mailing Address - Fax:
Practice Address - Street 1:14900 PRIVATE DRIVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112
Practice Address - Country:US
Practice Address - Phone:216-851-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COND. 2015192261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech