Provider Demographics
NPI:1083489637
Name:MEIER, THELMA MCKENZI (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:THELMA
Middle Name:MCKENZI
Last Name:MEIER
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 1:3015 DUPONT AVE S UNIT 2
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2706
Mailing Address - Country:US
Mailing Address - Phone:715-864-4359
Mailing Address - Fax:
Practice Address - Street 1:3400 W 66TH ST STE 300
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2110
Practice Address - Country:US
Practice Address - Phone:952-914-1965
Practice Address - Fax:952-914-1979
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN528351235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist