Healthcare Provider Details

I. General information

NPI: 1609668102
Provider Name (Legal Business Name): ABIGAIL VANHOUTEN MEEKS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14557 US-19 C
GRIFFIN GA
30224
US

IV. Provider business mailing address

136 MAIN ST
MILNER GA
30257-3844
US

V. Phone/Fax

Practice location:
  • Phone: 770-468-6941
  • Fax:
Mailing address:
  • Phone: 706-601-6782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP012378
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: