Provider Demographics
NPI:1861801656
Name:VAN LAAR, MEGAN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:VAN LAAR
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:LEIGH
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2461 10TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2461 10TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-1201
Practice Address - Country:US
Practice Address - Phone:319-358-6323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002268235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist