Provider Demographics
NPI:1922284868
Name:O'BRIEN, MEGHAN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1151
Mailing Address - Country:US
Mailing Address - Phone:339-686-2640
Mailing Address - Fax:
Practice Address - Street 1:11900 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1151
Practice Address - Country:US
Practice Address - Phone:339-686-2640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP7237SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist