Provider Demographics
NPI:1508276247
Name:BONDE, MEGHAN KATHLEEN (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:KATHLEEN
Last Name:BONDE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2922
Mailing Address - Country:US
Mailing Address - Phone:720-989-5502
Mailing Address - Fax:
Practice Address - Street 1:1401 61ST AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2922
Practice Address - Country:US
Practice Address - Phone:720-989-5502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-03
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC255747235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist