Provider Demographics
NPI:1144696634
Name:JUSTICE, MEREDITH LEE (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:LEE
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30055 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3230
Mailing Address - Country:US
Mailing Address - Phone:248-865-4166
Mailing Address - Fax:
Practice Address - Street 1:30055 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3230
Practice Address - Country:US
Practice Address - Phone:248-865-4166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000714231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist