Provider Demographics
NPI:1548534340
Name:EAST, MEGAN MARCHANT (SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARCHANT
Last Name:EAST
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10767 HWY 32 E
Mailing Address - Street 2:
Mailing Address - City:NICHOLLS
Mailing Address - State:GA
Mailing Address - Zip Code:31554-5410
Mailing Address - Country:US
Mailing Address - Phone:912-539-9546
Mailing Address - Fax:912-345-1095
Practice Address - Street 1:200 S TALLAHASSEE ST
Practice Address - Street 2:SUITE A & B
Practice Address - City:HAZLEHURST
Practice Address - State:GA
Practice Address - Zip Code:31539-6024
Practice Address - Country:US
Practice Address - Phone:912-345-4656
Practice Address - Fax:912-345-1095
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET001732235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist