Provider Demographics
NPI:1457449175
Name:KAPLAN, MICHAEL ALLAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLAN
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 CALLE DE MOLINA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-9261
Mailing Address - Country:US
Mailing Address - Phone:505-995-0415
Mailing Address - Fax:505-995-0415
Practice Address - Street 1:4001 OFFICE CT STE 305
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-4930
Practice Address - Country:US
Practice Address - Phone:505-466-7710
Practice Address - Fax:505-466-7714
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3956235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM42451051Medicaid