Provider Demographics
NPI:1962545095
Name:GERBINO, MEREDITH A (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:A
Last Name:GERBINO
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 1:623 GARDEN DISTRICT DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3020
Mailing Address - Country:US
Mailing Address - Phone:216-513-5665
Mailing Address - Fax:
Practice Address - Street 1:3403 LINDEN BERRY LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1300
Practice Address - Country:US
Practice Address - Phone:704-258-1724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7318235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist