Provider Demographics
NPI:1649605874
Name:HARDCASTLE, MEGGIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGGIE
Middle Name:
Last Name:HARDCASTLE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MEGGIE
Other - Middle Name:
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1902 HAIRSTON ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3227
Mailing Address - Country:US
Mailing Address - Phone:501-772-3599
Mailing Address - Fax:
Practice Address - Street 1:1902 HAIRSTON ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3227
Practice Address - Country:US
Practice Address - Phone:501-772-3599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1649605874Medicaid