Provider Demographics
NPI:1013189380
Name:MEREDITH, MICHELLE (AUD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 MIFFLIN AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-8846
Mailing Address - Country:US
Mailing Address - Phone:419-289-8919
Mailing Address - Fax:419-289-9563
Practice Address - Street 1:2212 MIFFLIN AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-8846
Practice Address - Country:US
Practice Address - Phone:419-289-8919
Practice Address - Fax:419-289-9563
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01502237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter