Provider Demographics
NPI:1952920209
Name:HARTLINE, MEGHAN LAURA
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LAURA
Last Name:HARTLINE
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 1:1332 CONSERVANCY DR E
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-6750
Mailing Address - Country:US
Mailing Address - Phone:850-443-0775
Mailing Address - Fax:
Practice Address - Street 1:114 3RD ST SE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-5401
Practice Address - Country:US
Practice Address - Phone:850-243-6134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist