Provider Demographics
NPI:1033452834
Name:FORSYTHE, MICHELLE SITRICK
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:SITRICK
Last Name:FORSYTHE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:ELIZABETH
Other - Last Name:SITRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2801 COHO ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4576
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2801 COHO ST STE 100
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-4576
Practice Address - Country:US
Practice Address - Phone:608-273-3232
Practice Address - Fax:608-237-8558
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist