Provider Demographics
NPI:1790156677
Name:CONYERS, MEAGAN
Entity Type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:
Last Name:CONYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 ORIOLE ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-6502
Mailing Address - Country:US
Mailing Address - Phone:870-307-1605
Mailing Address - Fax:
Practice Address - Street 1:116 ORIOLE ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-6502
Practice Address - Country:US
Practice Address - Phone:870-307-1605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-17
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15-0132355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant