Provider Demographics
NPI:1801442686
Name:ORTIZ, MEGAN FABIAN (CCC SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:FABIAN
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:MEGAN ANNE FABIAN
Other - Middle Name:ANNE
Other - Last Name:FABIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CCC SLP
Mailing Address - Street 1:3329 METAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5215
Mailing Address - Country:US
Mailing Address - Phone:504-565-7300
Mailing Address - Fax:504-565-7329
Practice Address - Street 1:3329 METAIRIE RD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5215
Practice Address - Country:US
Practice Address - Phone:504-565-7300
Practice Address - Fax:504-565-7329
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty