Provider Demographics
NPI:1518235506
Name:MEYERS, JEANNE ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:ELIZABETH
Last Name:MEYERS
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 1:66 DESTEFANO PL
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-5625
Mailing Address - Country:US
Mailing Address - Phone:518-843-1850
Mailing Address - Fax:
Practice Address - Street 1:11 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-4601
Practice Address - Country:US
Practice Address - Phone:518-843-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010606-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist