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General NPI Number Information
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NPI Number | 1245770403
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Entity Type | Individual
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Provider Name | MEREDITH D'AGOSTINO CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 380 CHAPEL ST
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City | STRATFORD
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State | CT
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Zip | 06614-1690
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Country | US
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Telephone | 203-882-1838
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Fax |
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Provider Business Mailing Address
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Address Line | 571 W RIVER ST
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City | MILFORD
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State | CT
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Zip | 06461-1952
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Country | US
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Telephone | 203-882-1838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 4851
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License Number State | CT
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