Provider Demographics
NPI:1407009822
Name:KNIGHT, MICHELE ANNE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:ANNE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 WOOD LN
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2647
Mailing Address - Country:US
Mailing Address - Phone:516-791-4989
Mailing Address - Fax:
Practice Address - Street 1:73 WOOD LN
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-2647
Practice Address - Country:US
Practice Address - Phone:516-791-4989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008738235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist