Provider Demographics
NPI:1164785275
Name:CROSS, MEREDITH KAY (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:KAY
Last Name:CROSS
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 1:816 EVERETTS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-9366
Mailing Address - Country:US
Mailing Address - Phone:910-619-2277
Mailing Address - Fax:910-319-7030
Practice Address - Street 1:1703 COUNTRY CLUB RD
Practice Address - Street 2:SUITE #305
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7560
Practice Address - Country:US
Practice Address - Phone:910-619-2277
Practice Address - Fax:910-319-7030
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NC6937235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist