Provider Demographics
NPI:1043730658
Name:MEYER, MONICA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MEYER
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 1:1891 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172-1442
Mailing Address - Country:US
Mailing Address - Phone:414-828-9252
Mailing Address - Fax:
Practice Address - Street 1:6735 W BRADLEY RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-3325
Practice Address - Country:US
Practice Address - Phone:414-354-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty