Provider Demographics
NPI:1194058503
Name:CHAVEZ, MEREDITH LEE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:LEE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 RANCHO SEGURO NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-5827
Mailing Address - Country:US
Mailing Address - Phone:505-615-6373
Mailing Address - Fax:
Practice Address - Street 1:8101 RANCHO SEGURO NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-5827
Practice Address - Country:US
Practice Address - Phone:505-615-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4792235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist