Provider Demographics
NPI:1265144562
Name:PENTECOST, MEGAN LYNN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYNN
Last Name:PENTECOST
Suffix:
Gender:F
Credentials:CCC-SLP
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Mailing Address - Street 1:9002 N MERIDIAN ST STE 222
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5350
Mailing Address - Country:US
Mailing Address - Phone:317-844-7059
Mailing Address - Fax:317-819-0044
Practice Address - Street 1:11725 ILLINOIS ST STE 445
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3010
Practice Address - Country:US
Practice Address - Phone:317-844-7059
Practice Address - Fax:317-819-0044
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN22008123A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist