Doctor Name: | MRS. MEGAN JEAN GARDNER |
NPI Number: | 1013314863 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 12153145 |
Business Practice Address: | 2221 W Detroit St Broken Arrow, OK - 740123628 |
Business Phone Number: | 9186156492 |
Business Fax Number: | 9186156493 |
Mailing Address: | 2221 W Detroit St, BROKEN ARROW |
State: | OK |
Postal Code: | 740123628 |
Phone Number: | 9186156492 |
Fax Number: | 9186156493 |
NPI Enumeration Date: | 11/21/2014 |
NPI Last Update Date: | 11/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12153145 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |