Provider Demographics
NPI:1073676136
Name:POMPER, MICHAEL SAUL (MA CCC SLP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SAUL
Last Name:POMPER
Suffix:
Gender:M
Credentials:MA CCC SLP
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:311 EAST 615 SOUTH
Mailing Address - Street 2:
Mailing Address - City:IVINS
Mailing Address - State:UT
Mailing Address - Zip Code:84738-5053
Mailing Address - Country:US
Mailing Address - Phone:436-656-3687
Mailing Address - Fax:
Practice Address - Street 1:1745 EAST 280 NORTH
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-628-5701
Practice Address - Fax:435-652-0186
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT62947984102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist