Provider Demographics
NPI:1639063316
Name:BODLEY, MEREDITH MARIE
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MARIE
Last Name:BODLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 RED TAIL LN
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-9649
Mailing Address - Country:US
Mailing Address - Phone:513-968-9459
Mailing Address - Fax:
Practice Address - Street 1:3881 THE RIDINGS
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3827
Practice Address - Country:US
Practice Address - Phone:513-314-8662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program