Provider Demographics
NPI:1912645532
Name:RICHEY, MEGHAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:RICHEY
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 1:1110 CORDWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-9338
Mailing Address - Country:US
Mailing Address - Phone:409-351-9601
Mailing Address - Fax:
Practice Address - Street 1:1110 CORDWOOD CIR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-9338
Practice Address - Country:US
Practice Address - Phone:409-351-9601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103706235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103706OtherTEXAS DEPARTMENT OF LICENSING AND REGULATIONS