Provider Demographics
NPI:1922471598
Name:HESTER, MEGAN KELLY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KELLY
Last Name:HESTER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 HUMPHREY AVE
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-1115
Mailing Address - Country:US
Mailing Address - Phone:201-978-9884
Mailing Address - Fax:
Practice Address - Street 1:133 HUMPHREY AVE
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-1115
Practice Address - Country:US
Practice Address - Phone:201-978-9884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00815700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist