Provider Demographics
NPI:1891088589
Name:DORNER, MEGAN FRANCES (MS CFY SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:FRANCES
Last Name:DORNER
Suffix:
Gender:F
Credentials:MS CFY SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 E. INDIAN SCHOOL RD.
Mailing Address - Street 2:AUDIOLOGY AND SPEECH PATHOLOGY (126)
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1892
Mailing Address - Country:US
Mailing Address - Phone:602-277-5551
Mailing Address - Fax:
Practice Address - Street 1:650 E. INDIAN SCHOOL ROAD
Practice Address - Street 2:AUDIOLOGY AND SPEECH PATHOLOGY (126)
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1892
Practice Address - Country:US
Practice Address - Phone:602-277-5551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP7236235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist