Provider Demographics
NPI:1679852180
Name:SCHLICHTING, MEAGAN A (MCD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:A
Last Name:SCHLICHTING
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2400
Mailing Address - Country:US
Mailing Address - Phone:864-380-0102
Mailing Address - Fax:
Practice Address - Street 1:420 E TERRACE AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2400
Practice Address - Country:US
Practice Address - Phone:864-380-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP7554235Z00000X
AZ7554235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist