Provider Demographics
NPI:1861776155
Name:SWAVELY, MEGAN DENISE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:DENISE
Last Name:SWAVELY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:DENISE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:P.O. BOX 670
Mailing Address - Street 2:3205 SKIPPACK PIKE
Mailing Address - City:WORCESTOR
Mailing Address - State:PA
Mailing Address - Zip Code:19490-0670
Mailing Address - Country:US
Mailing Address - Phone:610-584-3621
Mailing Address - Fax:610-222-8194
Practice Address - Street 1:3205 SKIPPACK PIKE
Practice Address - Street 2:
Practice Address - City:WORCESTOR
Practice Address - State:PA
Practice Address - Zip Code:19490-0670
Practice Address - Country:US
Practice Address - Phone:610-584-3621
Practice Address - Fax:610-222-8194
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010469235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist