Provider Demographics
NPI:1245770403
Name:D'AGOSTINO, MEREDITH (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:
Last Name:D'AGOSTINO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:MEREDITH
Other - Middle Name:
Other - Last Name:HONAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:571 W RIVER ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-1952
Mailing Address - Country:US
Mailing Address - Phone:203-882-1838
Mailing Address - Fax:
Practice Address - Street 1:380 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-1690
Practice Address - Country:US
Practice Address - Phone:203-882-1838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4851235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist