Provider Demographics
NPI:1366874935
Name:WHELAN, MEGAN ELIZABETH (MS CCC-SLP, QOM/CO)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:WHELAN
Suffix:
Gender:F
Credentials:MS CCC-SLP, QOM/CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 S 44TH PL
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8862
Mailing Address - Country:US
Mailing Address - Phone:314-852-2848
Mailing Address - Fax:
Practice Address - Street 1:17100 E SHEA BLVD
Practice Address - Street 2:#225
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-6625
Practice Address - Country:US
Practice Address - Phone:480-837-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP8429235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist