Provider Demographics
NPI:1790562957
Name:MEEKS, KIRSTEN E (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:E
Last Name:MEEKS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SWAN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6508
Mailing Address - Country:US
Mailing Address - Phone:907-738-5878
Mailing Address - Fax:
Practice Address - Street 1:65 WALNUT ST STE 580
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2194
Practice Address - Country:US
Practice Address - Phone:781-489-3697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
13587225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist