MEDICARE: MS. MEAGHEN MCCOY MA EDU

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	2355S0801X	Speech-Language Assistant

General Provider Information

NPI Number	:	1508891987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MEAGHEN MCCOY MA EDU

Provider Business Mailing Address
First Line	:	111 ELWYN RD
Second Line	:
City	:	ELWYN
State	:	PA
Zip	:	19063-4622
Country	:	US
Telephone Number	:	610-891-2294
Fax Number	:	610-891-2269

Provider Business Practice Location Address
First Line	:	111 ELWYN RD
Second Line	:
City	:	ELWYN
State	:	PA
Zip	:	19063-4622
Country	:	US
Telephone Number	:	610-891-2294
Fax Number	:	610-891-2269

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/08/2007

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