Provider Demographics
NPI:1063740223
Name:MEITUS, VICKI LYNN (MA)
Entity type:Individual
Prefix:MS
First Name:VICKI
Middle Name:LYNN
Last Name:MEITUS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1348
Mailing Address - Country:US
Mailing Address - Phone:610-825-9360
Mailing Address - Fax:
Practice Address - Street 1:502 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1348
Practice Address - Country:US
Practice Address - Phone:610-825-9360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002865L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist