Provider Demographics
NPI:1780038794
Name:COOKSON, MEREDITH ABERNETHY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ABERNETHY
Last Name:COOKSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1009 N CALDWELL ST APT 2211
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-3602
Mailing Address - Country:US
Mailing Address - Phone:828-458-0374
Mailing Address - Fax:
Practice Address - Street 1:185 CHARLOIS BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1521
Practice Address - Country:US
Practice Address - Phone:336-725-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-15
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12348OtherNC BOE LICENSE