MEDICARE: MEGHAN M DICK M.S, 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
1	235Z00000X	Speech-Language Pathologist	3267-154	WI

General Provider Information

NPI Number	:	1427287648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN M DICK M.S, CCC-SLP

Provider Business Mailing Address
First Line	:	7401 TETIVA RD
Second Line	:
City	:	SAUK CITY
State	:	WI
Zip	:	53583-9705
Country	:	US
Telephone Number	:	715-797-0786
Fax Number	:

Provider Business Practice Location Address
First Line	:	7401 TETIVA RD
Second Line	:
City	:	SAUK CITY
State	:	WI
Zip	:	53583-9705
Country	:	US
Telephone Number	:	715-797-0786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2009
Last Update Date	:	08/19/2013

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