Provider Demographics
NPI:1326418393
Name:LEWIS, MEAGAN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 20TH AVE S APT 1605
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-2250
Mailing Address - Country:US
Mailing Address - Phone:860-690-4304
Mailing Address - Fax:
Practice Address - Street 1:900 20TH AVE S APT 1605
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2250
Practice Address - Country:US
Practice Address - Phone:860-690-4304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-02
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76512235Z00000X
TN235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist