Provider Demographics
NPI:1477070936
Name:MCFERRAN, MICHELLE M (MSED)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:M
Last Name:MCFERRAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 WARREN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2225
Mailing Address - Country:US
Mailing Address - Phone:860-605-8106
Mailing Address - Fax:
Practice Address - Street 1:201 QUAKER LN
Practice Address - Street 2:
Practice Address - City:DELANSON
Practice Address - State:NY
Practice Address - Zip Code:12053-2833
Practice Address - Country:US
Practice Address - Phone:518-366-9675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-25
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY028357235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty