Healthcare Provider Details

I. General information

NPI: 1891987632
Provider Name (Legal Business Name): MEREDITH S BROWN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 HIGHWAY 4 E
HOLLY SPRINGS MS
38635-2112
US

IV. Provider business mailing address

1315 HIGHWAY 4 E
HOLLY SPRINGS MS
38635-2112
US

V. Phone/Fax

Practice location:
  • Phone: 662-252-1141
  • Fax: 662-252-4836
Mailing address:
  • Phone: 662-252-1141
  • Fax: 662-252-4836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberS3000
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: