Provider Demographics
NPI:1740821487
Name:MORROW, MEGAN WILLIS (MS)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:WILLIS
Last Name:MORROW
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:WILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3924 HOLLYHOCK WAY
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7620
Mailing Address - Country:US
Mailing Address - Phone:415-722-0327
Mailing Address - Fax:
Practice Address - Street 1:1130 GROVE ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2914
Practice Address - Country:US
Practice Address - Phone:415-722-0327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14071235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist