Provider Demographics
NPI:1902098379
Name:ROGALSKI, MEGAN THERESE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:THERESE
Last Name:ROGALSKI
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:THERESE
Other - Last Name:VINOPAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CFY-SLP
Mailing Address - Street 1:4525 W ENCANTO BLVD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035-2213
Mailing Address - Country:US
Mailing Address - Phone:602-442-2500
Mailing Address - Fax:
Practice Address - Street 1:4525 W ENCANTO BLVD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-2213
Practice Address - Country:US
Practice Address - Phone:602-442-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP5576235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist