Provider Demographics
NPI:1003477654
Name:MENUDIER, MEREDITH FISHER
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:FISHER
Last Name:MENUDIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 E GASTON ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-4400
Mailing Address - Country:US
Mailing Address - Phone:980-212-7020
Mailing Address - Fax:704-735-5256
Practice Address - Street 1:16455 STATESVILLE RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7135
Practice Address - Country:US
Practice Address - Phone:704-801-3719
Practice Address - Fax:704-801-3705
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4790235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist