Doctor Name: | MS. MEGHAN MARIE BLOM |
NPI Number: | 1205143617 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCC-SLP |
License Number: | 019247-1 |
Business Practice Address: | 1014 Grand Blvd Suite 5 Deer Park, NY - 117295782 |
Business Phone Number: | 6312431765 |
Business Fax Number: | |
Mailing Address: | 7 Glen Hollow Dr, Apt B38 HOLTSVILLE |
State: | NY |
Postal Code: | 117422445 |
Phone Number: | 6313358725 |
Fax Number: | |
NPI Enumeration Date: | 09/07/2010 |
NPI Last Update Date: | 09/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 019247-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |