Provider Demographics
NPI:1447738240
Name:THOMAS, MEENU E (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEENU
Middle Name:E
Last Name:THOMAS
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 1:2421 NE 65TH ST APT 411
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1559
Mailing Address - Country:US
Mailing Address - Phone:908-265-0416
Mailing Address - Fax:
Practice Address - Street 1:4301 S FLAMINGO RD STE 101
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-1902
Practice Address - Country:US
Practice Address - Phone:954-312-3449
Practice Address - Fax:954-251-2752
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8629235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist