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NPI Code Detail

MEDICARE: MEGAN K WARDLOW M.A., CCC-SLP

MEDICARE: MEGAN K WARDLOW M.A., 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 Pathologist146010244IL

General Provider Information

NPI Number : 1790006310
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN K WARDLOW M.A., CCC-SLP
Provider Business Mailing Address
First Line : 804 STATE ST
Second Line : #5
City : QUINCY
State : IL
Zip : 62301-4968
Country : US
Telephone Number : 217-224-1750
Fax Number : 217-224-0403
Provider Business Practice Location Address
First Line : 804 STATE ST
Second Line : #5
City : QUINCY
State : IL
Zip : 62301-4968
Country : US
Telephone Number : 217-224-1750
Fax Number : 217-224-0403
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2010
Last Update Date : 06/17/2010

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Directions to “ MEGAN K WARDLOW M.A., CCC-SLP” Practice Location

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