Provider Demographics
NPI:1457754889
Name:VALLES, MEAGAN
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:VALLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0425
Mailing Address - Country:US
Mailing Address - Phone:207-322-9176
Mailing Address - Fax:
Practice Address - Street 1:529 FILES HILL RD
Practice Address - Street 2:
Practice Address - City:THORNDIKE
Practice Address - State:ME
Practice Address - Zip Code:04986-3112
Practice Address - Country:US
Practice Address - Phone:207-322-9176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESAS23812355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant