Provider Demographics
NPI:1013371145
Name:YORK, MICHAEL (SLP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:YORK
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 ROCKY SHORE DR
Mailing Address - Street 2:
Mailing Address - City:ORRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04474-3902
Mailing Address - Country:US
Mailing Address - Phone:207-299-2627
Mailing Address - Fax:
Practice Address - Street 1:100 HOLMES ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2626
Practice Address - Country:US
Practice Address - Phone:207-594-2008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1721235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist