Healthcare Provider Details

I. General information

NPI: 1215494570
Provider Name (Legal Business Name): MEGAN VROOMAN M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MAIN ST
PLAISTOW NH
03865-3014
US

IV. Provider business mailing address

120 MAIN ST
PLAISTOW NH
03865-3014
US

V. Phone/Fax

Practice location:
  • Phone: 603-382-7146
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number77146-SP-SL
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1905
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: