Provider Demographics
NPI:1225578537
Name:MEGNIN, KATIE
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:MEGNIN
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 1:4413 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3326
Mailing Address - Country:US
Mailing Address - Phone:804-368-0485
Mailing Address - Fax:804-269-0252
Practice Address - Street 1:4413 COX RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3326
Practice Address - Country:US
Practice Address - Phone:804-368-0485
Practice Address - Fax:804-269-0252
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007448235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist