Provider Demographics
NPI:1013469519
Name:SPENCER, MEGAN MCLAIN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MCLAIN
Last Name:SPENCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MCLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 BLUEBIRD LN
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2302
Mailing Address - Country:US
Mailing Address - Phone:615-792-5664
Mailing Address - Fax:
Practice Address - Street 1:320 BLUEBIRD LN
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2302
Practice Address - Country:US
Practice Address - Phone:615-792-5664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist