Healthcare Provider Details

I. General information

NPI: 1801240437
Provider Name (Legal Business Name): MEGAN PRESTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9403 N GRANBY AVE
KANSAS CITY MO
64154-1383
US

IV. Provider business mailing address

9403 N GRANBY AVE
KANSAS CITY MO
64154-1383
US

V. Phone/Fax

Practice location:
  • Phone: 816-258-3129
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2016006633
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: