Provider Demographics
NPI:1275829491
Name:DAVIDSON, MEGAN COKER (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:COKER
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:COKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2210 E MANOR DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-2640
Mailing Address - Country:US
Mailing Address - Phone:832-876-7812
Mailing Address - Fax:
Practice Address - Street 1:2210 E MANOR DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-2640
Practice Address - Country:US
Practice Address - Phone:832-876-7812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202569235Z00000X
TX106852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75-1282040Medicaid