Provider Demographics
NPI:1184310138
Name:ISAACSON, MEGAN ELAINE CLARKE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELAINE CLARKE
Last Name:ISAACSON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10352 OAKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-2273
Mailing Address - Country:US
Mailing Address - Phone:435-890-0897
Mailing Address - Fax:
Practice Address - Street 1:10352 OAKSIDE DR
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-2273
Practice Address - Country:US
Practice Address - Phone:435-890-0897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20327235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist