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NPI Code Detail

MEDICARE: MEREDITH LINCOLN

MEDICARE: MEREDITH LINCOLN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1437790615
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEREDITH LINCOLN
Provider Business Mailing Address
First Line : 1115 W CHESTNUT ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-7501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1115 W CHESTNUT ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-7501
Country : US
Telephone Number : 508-559-0473
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2019
Last Update Date : 04/16/2026

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Directions to “ MEREDITH LINCOLN ” Practice Location

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