Provider Demographics
NPI:1902053580
Name:RESNICK, MEREDITH L (MA CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:L
Last Name:RESNICK
Suffix:
Gender:F
Credentials:MA CCC-A
Other - Prefix:MISS
Other - First Name:MEREDITH
Other - Middle Name:L
Other - Last Name:SIEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6110 W ATLANTIC AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8405
Mailing Address - Country:US
Mailing Address - Phone:561-638-6530
Mailing Address - Fax:561-638-6531
Practice Address - Street 1:6110 W ATLANTIC AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8405
Practice Address - Country:US
Practice Address - Phone:561-638-6530
Practice Address - Fax:561-638-6531
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1761231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHH387ZMedicare UPIN