Healthcare Provider Details

I. General information

NPI: 1134544786
Provider Name (Legal Business Name): KERRY MEGGITT M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2014
Last Update Date: 02/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5906 BOGART RD W
CASTALIA OH
44824-9714
US

IV. Provider business mailing address

1210 E BOGART RD
SANDUSKY OH
44870-6411
US

V. Phone/Fax

Practice location:
  • Phone: 419-684-5357
  • Fax:
Mailing address:
  • Phone: 419-627-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP6993
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: