Provider Demographics
NPI:1700039609
Name:FARWELL, MEGAN L (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:L
Last Name:FARWELL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:L
Other - Last Name:DAIGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:50 CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12302-4344
Mailing Address - Country:US
Mailing Address - Phone:518-384-3833
Mailing Address - Fax:518-383-3834
Practice Address - Street 1:50 CYPRESS DR
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12302-4344
Practice Address - Country:US
Practice Address - Phone:518-384-3833
Practice Address - Fax:518-383-3834
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012141-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist