Provider Demographics
NPI:1639533367
Name:SEAGER, MEGAN VIRGINIA (4246-154)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:VIRGINIA
Last Name:SEAGER
Suffix:
Gender:F
Credentials:4246-154
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 COMMERCE DRIVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53406
Mailing Address - Country:US
Mailing Address - Phone:262-886-3431
Mailing Address - Fax:262-886-3954
Practice Address - Street 1:1100 COMMERCE DRIVE
Practice Address - Street 2:SUITE 114
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406
Practice Address - Country:US
Practice Address - Phone:262-886-3431
Practice Address - Fax:262-886-3954
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41205000Medicaid