Healthcare Provider Details

I. General information

NPI: 1073282604
Provider Name (Legal Business Name): MEGAN EDDINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 W 4TH ST STE 10
FOSTORIA OH
44830-1864
US

IV. Provider business mailing address

455 W 4TH ST STE 10
FOSTORIA OH
44830-1864
US

V. Phone/Fax

Practice location:
  • Phone: 419-436-8320
  • Fax:
Mailing address:
  • Phone: 419-436-8320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCOND.20263474-SP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: