Provider Demographics
NPI:1811324338
Name:HAMM, MEGAN D (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:D
Last Name:HAMM
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BUDD AVE
Mailing Address - Street 2:APT O8
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-4064
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 BUDD AVE
Practice Address - Street 2:APT O8
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-4064
Practice Address - Country:US
Practice Address - Phone:805-459-3282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-29
Last Update Date:2013-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 19914235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist