MEDICARE: MS. MEGAN ANN ESTOK 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	SP8319	OH

General Provider Information

NPI Number	:	1689875999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MEGAN ANN ESTOK CCC-SLP

Provider Business Mailing Address
First Line	:	5152 YORK COUNTY RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-5556
Country	:	US
Telephone Number	:	614-293-4247
Fax Number	:	614-293-5220

Provider Business Practice Location Address
First Line	:	2050 KENNY RD
Second Line	:	SUITE 2145
City	:	COLUMBUS
State	:	OH
Zip	:	43221-3502
Country	:	US
Telephone Number	:	614-293-4247
Fax Number	:	614-293-5220

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

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	07/08/2007

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Directions to “ MS. MEGAN ANN ESTOK CCC-SLP” Practice Location

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