Provider Demographics
NPI:1598166407
Name:SHEARER, MEGAN KATHLEEN (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:KATHLEEN
Last Name:SHEARER
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 1:8310 S 48TH LN
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-7347
Mailing Address - Country:US
Mailing Address - Phone:520-631-7016
Mailing Address - Fax:
Practice Address - Street 1:13460 N 67TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1000
Practice Address - Country:US
Practice Address - Phone:623-334-5404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ SLP 5531235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist