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General NPI Number Information
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NPI Number | 1851019343
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Entity Type | Individual
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Provider Name | MEGAN JESSUP M.S.
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Gender | Female
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Dates
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Enumeration Date | 08/19/2022
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 801 N 11TH ST
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City | SAINT LOUIS
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State | MO
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Zip | 63101-1015
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Country | US
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Telephone | 314-633-5344
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Fax |
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Provider Business Mailing Address
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Address Line | 421 S MAIN ST
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City | WATERLOO
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State | IL
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Zip | 62298-1443
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Country | US
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Telephone | 618-335-4226
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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 | IL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2024027781
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License Number State | MO
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