Provider Demographics
NPI:1972374031
Name:CRUM, MEREDITH ANN (LAC, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:ANN
Last Name:CRUM
Suffix:
Gender:F
Credentials:LAC, 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:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:FOLLY BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29439
Mailing Address - Country:US
Mailing Address - Phone:901-626-5626
Mailing Address - Fax:
Practice Address - Street 1:56 1/2 QUEEN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401
Practice Address - Country:US
Practice Address - Phone:843-637-3237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5320235Z00000X
SC395171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist