Provider Demographics
NPI:1457673832
Name:MEEHAN, MARY LUCILLE (DT-H)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LUCILLE
Last Name:MEEHAN
Suffix:
Gender:F
Credentials:DT-H
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 BRANFORD LANE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564
Mailing Address - Country:US
Mailing Address - Phone:630-904-4957
Mailing Address - Fax:
Practice Address - Street 1:1520 BRANFORD LANE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564
Practice Address - Country:US
Practice Address - Phone:630-904-4957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist