Provider Demographics
NPI:1992142756
Name:FERGUSON, MEGAN E (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:E
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CELEBRATION PL STE 305
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5436
Mailing Address - Country:US
Mailing Address - Phone:407-303-4120
Mailing Address - Fax:407-303-4124
Practice Address - Street 1:410 CELEBRATION PL STE 305
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5436
Practice Address - Country:US
Practice Address - Phone:407-303-4120
Practice Address - Fax:407-303-4124
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11351235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist