Healthcare Provider Details

I. General information

NPI: 1073877106
Provider Name (Legal Business Name): MEGAN NICOLE WHEELER CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2012
Last Update Date: 07/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 FRANCES MEEKS WAY SUITE 9
RICHMOND HILL GA
31324-3983
US

IV. Provider business mailing address

6315 GARRARD AVE
SAVANNAH GA
31405-2736
US

V. Phone/Fax

Practice location:
  • Phone: 912-727-2321
  • Fax: 912-445-0599
Mailing address:
  • Phone: 912-659-8203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPCET001778
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: