Provider Demographics
NPI:1962978817
Name:COLE, MEGAN (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:
Last Name:COLE
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 1:5001 EASTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45432-1499
Mailing Address - Country:US
Mailing Address - Phone:937-259-6635
Mailing Address - Fax:
Practice Address - Street 1:5001 EASTMAN AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45432-1499
Practice Address - Country:US
Practice Address - Phone:937-259-6635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.12749235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist