Provider Demographics
NPI:1548516453
Name:WARREN, MEGAN GRACE (MS CCC SLP TSSLD)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:GRACE
Last Name:WARREN
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Gender:F
Credentials:MS CCC SLP TSSLD
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Mailing Address - Street 1:97 PARK AVE UNIT 23
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7608
Mailing Address - Country:US
Mailing Address - Phone:914-943-8577
Mailing Address - Fax:914-593-0594
Practice Address - Street 1:503 GRASSLANDS RD STE 101
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1520
Practice Address - Country:US
Practice Address - Phone:914-593-0593
Practice Address - Fax:914-593-0594
Is Sole Proprietor?:No
Enumeration Date:2012-07-29
Last Update Date:2022-11-23
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Provider Licenses
StateLicense IDTaxonomies
NY0223341235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03655676Medicaid