MEDICARE: MEREDITH RICHARDS SPEECH THERAPY

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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1699573691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEREDITH RICHARDS SPEECH THERAPY

Provider Business Mailing Address
First Line	:	4230 RALEIGH AVE
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55416-3237
Country	:	US
Telephone Number	:	612-790-7970
Fax Number	:

Provider Business Practice Location Address
First Line	:	4230 RALEIGH AVE
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55416-3237
Country	:	US
Telephone Number	:	612-790-7970
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	MEREDITH RICHARDS
Credential	:	M.S.
Telephone Number	:	612-790-7970

Provider Enumeration Date	:	03/05/2025
Last Update Date	:	03/05/2025

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