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General NPI Number Information
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NPI Number | 1023490422
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Entity Type | Individual
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Provider Name | MEGAN K CARLSON CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 9401 OLD SAUK RD
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City | MIDDLETON
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State | WI
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Zip | 53562-4409
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Country | US
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Telephone | 608-373-5284
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Fax |
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Provider Business Mailing Address
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Address Line | 913 SHERMAN AVE W
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City | FORT ATKINSON
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State | WI
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Zip | 53538-1534
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Country | US
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Telephone | 708-601-3939
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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