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Individual

MEREDITH JOAN PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA/CCC-SLP

Contact information

Practice address
660 MCQUEEN SMITH RD N STE H, PRATTVILLE, AL 36066-7559
(334) 350-3362
Mailing address
375 ASHTON PARK, MILLBROOK, AL 36054-1854
(662) 435-0817

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5004
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5004
ALABAMA BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
AL
Enumeration date
08/09/2021
Last updated
08/09/2021
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