Healthcare Provider Details

I. General information

NPI: 1124733381
Provider Name (Legal Business Name): MEGAN PATER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN BALLANTYNE

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 BEAVER GRADE RD STE 120
MOON TOWNSHIP PA
15108-2964
US

IV. Provider business mailing address

1345 ENTERPRISE DR
WEST CHESTER PA
19380-5964
US

V. Phone/Fax

Practice location:
  • Phone: 412-742-0964
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL014832
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: