Provider Demographics
NPI:1356638282
Name:MEHLHOFF, MICHELLE LEE (MS,CFY-SLP)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:LEE
Last Name:MEHLHOFF
Suffix:
Gender:F
Credentials:MS,CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2536
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58502-2536
Mailing Address - Country:US
Mailing Address - Phone:701-258-1569
Mailing Address - Fax:701-223-1669
Practice Address - Street 1:1911 N 11TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1915
Practice Address - Country:US
Practice Address - Phone:701-258-1569
Practice Address - Fax:701-223-1669
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1174235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist