Provider Demographics
NPI:1750910782
Name:OCAMPO, MEGAN NICOLE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:OCAMPO
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 1:5420 MCCORMICK RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2902
Mailing Address - Country:US
Mailing Address - Phone:704-619-1890
Mailing Address - Fax:
Practice Address - Street 1:5420 MCCORMICK RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2902
Practice Address - Country:US
Practice Address - Phone:704-619-1890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14068235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist