Provider Demographics
NPI:1346760709
Name:HARDER, MICHELLE CHRISTINA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:CHRISTINA
Last Name:HARDER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:GREY HARDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:11100 COLOMA RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2804
Mailing Address - Country:US
Mailing Address - Phone:916-361-7290
Mailing Address - Fax:
Practice Address - Street 1:11100 COLOMA RD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-2804
Practice Address - Country:US
Practice Address - Phone:916-361-7290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10526235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10526OtherSLP