Provider Demographics
NPI:1255618633
Name:NIEMEYER, MEGHAN JOYCE (CSCD)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:JOYCE
Last Name:NIEMEYER
Suffix:
Gender:F
Credentials:CSCD
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:JOYCE
Other - Last Name:BERTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSCD
Mailing Address - Street 1:25425 WRIGHT PL
Mailing Address - Street 2:
Mailing Address - City:JONESBURG
Mailing Address - State:MO
Mailing Address - Zip Code:63351-2444
Mailing Address - Country:US
Mailing Address - Phone:314-401-4700
Mailing Address - Fax:
Practice Address - Street 1:25425 WRIGHT PL
Practice Address - Street 2:
Practice Address - City:JONESBURG
Practice Address - State:MO
Practice Address - Zip Code:63351-2444
Practice Address - Country:US
Practice Address - Phone:314-401-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-13
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146014674235Z00000X
MO2012019885235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist