Provider Demographics
NPI:1316183361
Name:DUNN, MEREDITH KATHRYN WILSON (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:KATHRYN WILSON
Last Name:DUNN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:KATHRYN
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:3049 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1644
Mailing Address - Country:US
Mailing Address - Phone:315-445-4010
Mailing Address - Fax:
Practice Address - Street 1:3049 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1644
Practice Address - Country:US
Practice Address - Phone:315-445-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016870-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist