Provider Demographics
NPI:1326805649
Name:POE, MICAELA LINDSEY (SLP-A)
Entity Type:Individual
Prefix:
First Name:MICAELA
Middle Name:LINDSEY
Last Name:POE
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 STATE HIGHWAY 248 STE 4
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-9627
Mailing Address - Country:US
Mailing Address - Phone:417-546-7994
Mailing Address - Fax:
Practice Address - Street 1:2404 STATE HIGHWAY 248 STE 4
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-9627
Practice Address - Country:US
Practice Address - Phone:417-320-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant