Provider Demographics
NPI:1043474711
Name:HILEMAN, MICHELLE (MS CCCSLP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:HILEMAN
Suffix:
Gender:F
Credentials:MS CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 ADAMS ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAINT HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-1164
Mailing Address - Country:US
Mailing Address - Phone:707-967-1087
Mailing Address - Fax:
Practice Address - Street 1:1104 ADAMS ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-1164
Practice Address - Country:US
Practice Address - Phone:707-967-1087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP16456235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist