Provider Demographics
NPI:1366794943
Name:MEREDITH, LINETTE NICOLE (PHD,CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:LINETTE
Middle Name:NICOLE
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:PHD,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N SAMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-3929
Mailing Address - Country:US
Mailing Address - Phone:901-598-5853
Mailing Address - Fax:
Practice Address - Street 1:620 N SAMPSON AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-3929
Practice Address - Country:US
Practice Address - Phone:901-598-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP0000004447235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist