1134155203 NPI number — MS. MEREDITH ANN COOK MS CCC SLP

Table of content: MS. MEREDITH ANN COOK MS CCC SLP (NPI 1134155203)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134155203 NPI number — MS. MEREDITH ANN COOK MS CCC SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOK
Provider First Name:
MEREDITH
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS CCC SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARRISON
Provider Other First Name:
MEREDITH
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS CCC SLP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1134155203
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2918 HAWKINS DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEARCY
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72143
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-179-9255
Provider Business Mailing Address Fax Number:
501-279-9257

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2918 HAWKINS DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEARCY
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-179-9255
Provider Business Practice Location Address Fax Number:
501-279-9257
Provider Enumeration Date:
06/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  ST1910 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com