Provider Demographics
NPI:1902197528
Name:TERWILLIGER, MERI LYN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MERI
Middle Name:LYN
Last Name:TERWILLIGER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 PERSHING ST
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2032
Mailing Address - Country:US
Mailing Address - Phone:607-215-4476
Mailing Address - Fax:
Practice Address - Street 1:25 PERSHING ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2032
Practice Address - Country:US
Practice Address - Phone:607-215-4476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017189235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist