Provider Demographics
NPI:1619023587
Name:HERING, MEGAN A (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:A
Last Name:HERING
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8530 GREENWAY BLVD
Mailing Address - Street 2:UNIT 207
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-3588
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5330 CENTURY AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-2007
Practice Address - Country:US
Practice Address - Phone:608-203-8880
Practice Address - Fax:608-203-8881
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2645-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1619023587Medicaid