Provider Demographics
NPI:1942062633
Name:MEEKS, LISA (MM, MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:MEEKS
Suffix:
Gender:F
Credentials:MM, MA, CCC-SLP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:JEANES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MM, MA
Mailing Address - Street 1:1309 MCCARTHY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2035
Mailing Address - Country:US
Mailing Address - Phone:252-560-1747
Mailing Address - Fax:
Practice Address - Street 1:1309 MCCARTHY BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2035
Practice Address - Country:US
Practice Address - Phone:252-560-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30001521235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist