Provider Demographics
NPI:1124518048
Name:FOLSOM, MEGAN NICOLE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:FOLSOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5239 WINCEY GROVES RD
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-8605
Mailing Address - Country:US
Mailing Address - Phone:727-543-9034
Mailing Address - Fax:
Practice Address - Street 1:4705 S APOPKA VINELAND RD STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-3151
Practice Address - Country:US
Practice Address - Phone:407-905-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist