Provider Demographics
NPI:1336415165
Name:JONES, MEGAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:JONES
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 1:300 CAMBRIDGE TPKE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-2304
Mailing Address - Country:US
Mailing Address - Phone:570-262-7876
Mailing Address - Fax:617-244-8312
Practice Address - Street 1:300 CAMBRIDGE TPKE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-2304
Practice Address - Country:US
Practice Address - Phone:570-262-7876
Practice Address - Fax:617-244-8312
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7771235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist