Provider Demographics
NPI:1952654717
Name:FLANAGAN, MARGARET ELAINE (MS, SLP-CCC)
Entity Type:Individual
Prefix:MISS
First Name:MARGARET
Middle Name:ELAINE
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 E JEFF DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-2303
Mailing Address - Country:US
Mailing Address - Phone:662-299-9774
Mailing Address - Fax:
Practice Address - Street 1:113 E JEFF DAVIS AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-2303
Practice Address - Country:US
Practice Address - Phone:662-299-9774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3442235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist