Provider Demographics
NPI:1700315876
Name:KRADY, MERYL B (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MERYL
Middle Name:B
Last Name:KRADY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MERYL
Other - Middle Name:BETH
Other - Last Name:FINEBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:2005 OAKHURST PKWY
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1125
Mailing Address - Country:US
Mailing Address - Phone:609-876-7944
Mailing Address - Fax:
Practice Address - Street 1:2005 OAKHURST PKWY
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1125
Practice Address - Country:US
Practice Address - Phone:609-876-7944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00940800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist