Provider Demographics
NPI:1639318025
Name:RICHMOND, MEGAN LYNETTE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MEGAN LYNETTE
Middle Name:
Last Name:RICHMOND
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 1:103 CLAIR DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-6400
Mailing Address - Country:US
Mailing Address - Phone:864-295-0944
Mailing Address - Fax:
Practice Address - Street 1:103 CLAIR DR
Practice Address - Street 2:SUITE A
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-6400
Practice Address - Country:US
Practice Address - Phone:864-295-0944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4279235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist