Provider Demographics
NPI:1003559584
Name:MICHAUD, TASHIA
Entity Type:Individual
Prefix:
First Name:TASHIA
Middle Name:
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-4706
Mailing Address - Country:US
Mailing Address - Phone:860-674-8558
Mailing Address - Fax:
Practice Address - Street 1:47 W MAIN ST
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-4706
Practice Address - Country:US
Practice Address - Phone:860-674-8558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist