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NPI Code Detail

MEDICARE: MS. MEGAN MICHELLE PANATIER MS, CCC-SLP

MEDICARE: MS. MEGAN MICHELLE PANATIER MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist16060CA

General Provider Information

NPI Number : 1326169301
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MEGAN MICHELLE PANATIER MS, CCC-SLP
Provider Business Mailing Address
First Line : 15 PALOMA AVE
Second Line : #16
City : VENICE
State : CA
Zip : 90291-8711
Country : US
Telephone Number : 310-392-7587
Fax Number :
Provider Business Practice Location Address
First Line : 6340 VARIEL AVE
Second Line : SUITE A
City : WOODLAND HILLS
State : CA
Zip : 91367-2514
Country : US
Telephone Number : 818-888-4559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 08/14/2007

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