Healthcare Provider Details

I. General information

NPI: 1538347885
Provider Name (Legal Business Name): LAURIE ANN MEUNIER CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 02/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HORTON RD STE A
JACKSON MI
49203-5177
US

IV. Provider business mailing address

1019 S GRINNELL ST
JACKSON MI
49203-2974
US

V. Phone/Fax

Practice location:
  • Phone: 517-784-5043
  • Fax:
Mailing address:
  • Phone: 517-784-7454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: