Provider Demographics
NPI:1841560687
Name:OUELLETTE, MEREDITH SMALLEY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:SMALLEY
Last Name:OUELLETTE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:4880 MACARTHUR BLVD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1557
Mailing Address - Country:US
Mailing Address - Phone:202-333-1403
Mailing Address - Fax:202-333-1404
Practice Address - Street 1:4880 MACARTHUR BLVD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-1557
Practice Address - Country:US
Practice Address - Phone:202-333-1403
Practice Address - Fax:202-333-1404
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004057235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist