Provider Demographics
NPI:1912503111
Name:DOPSON, MEGAN ANN
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ANN
Last Name:DOPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 AVINGTON CHASE
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-4888
Mailing Address - Country:US
Mailing Address - Phone:470-898-0899
Mailing Address - Fax:
Practice Address - Street 1:905 ARROWHEAD TRL
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-5390
Practice Address - Country:US
Practice Address - Phone:478-333-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010784235Z00000X
GA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty