MEDICARE: MRS. MEGAN P PERKINS M.A.,CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP9196	OH

General Provider Information

NPI Number	:	1730323742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGAN P PERKINS M.A.,CCC-SLP

Provider Business Mailing Address
First Line	:	150 N MILLER RD
Second Line	:	#150A
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-3770
Country	:	US
Telephone Number	:	330-867-2240
Fax Number	:	330-867-2245

Provider Business Practice Location Address
First Line	:	150 N MILLER RD
Second Line	:	#150A
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-3770
Country	:	US
Telephone Number	:	330-867-2240
Fax Number	:	330-867-2245

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2009
Last Update Date	:	04/22/2009

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