Provider Demographics
NPI:1467808899
Name:MEEK, DESIREE (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:MEEK
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 GARDEN PL
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-5011
Mailing Address - Country:US
Mailing Address - Phone:732-822-4707
Mailing Address - Fax:
Practice Address - Street 1:472 GARDEN PLACE
Practice Address - Street 2:
Practice Address - City:KEYPORT
Practice Address - State:NJ
Practice Address - Zip Code:07735
Practice Address - Country:US
Practice Address - Phone:732-441-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00469300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist