Provider Demographics
NPI:1063609071
Name:LOCKARD, MEGHAN KLUZ (SCD)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:KLUZ
Last Name:LOCKARD
Suffix:
Gender:F
Credentials:SCD
Other - Prefix:DR
Other - First Name:MEGHAN
Other - Middle Name:D
Other - Last Name:KLUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SCD
Mailing Address - Street 1:30 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1914
Mailing Address - Country:US
Mailing Address - Phone:201-996-5337
Mailing Address - Fax:201-996-0557
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1914
Practice Address - Country:US
Practice Address - Phone:201-996-5337
Practice Address - Fax:201-996-0557
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00071200231H00000X
NJ25MG00109700237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter