Provider Demographics
NPI:1760734776
Name:SIMON, MEGAN K (BA)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:K
Last Name:SIMON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:K
Other - Last Name:SUMNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:7051 MADDOX DR APT 43
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4427
Mailing Address - Country:US
Mailing Address - Phone:714-334-7478
Mailing Address - Fax:
Practice Address - Street 1:7051 MADDOX DR APT 43
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-4427
Practice Address - Country:US
Practice Address - Phone:714-334-7478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16782355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant