Provider Demographics
NPI:1750909552
Name:MEREDITH, MARY CHARLOTTE (CF-SLP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CHARLOTTE
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4316 ROCKHILL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-1533
Mailing Address - Country:US
Mailing Address - Phone:620-200-5307
Mailing Address - Fax:
Practice Address - Street 1:14820 E 42ND ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-4775
Practice Address - Country:US
Practice Address - Phone:816-695-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist