Provider Demographics
NPI:1811096373
Name:ABRAHAM, MEGHAN MARIE WALSH (AUD)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:MARIE WALSH
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:MARIE
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2121 E HARMONY RD UNIT 350B
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3404
Mailing Address - Country:US
Mailing Address - Phone:970-484-6373
Mailing Address - Fax:970-484-0382
Practice Address - Street 1:2121 E HARMONY RD UNIT 350B
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3404
Practice Address - Country:US
Practice Address - Phone:970-484-6373
Practice Address - Fax:970-484-0382
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO275231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO88384322Medicaid