Provider Demographics
NPI:1821253691
Name:BURKS, MEGAN L (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:BURKS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 LEGACY LN
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8754
Mailing Address - Country:US
Mailing Address - Phone:870-918-5697
Mailing Address - Fax:
Practice Address - Street 1:1700 SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-6455
Practice Address - Country:US
Practice Address - Phone:501-327-2715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
AR121147155235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist