Provider Demographics
NPI:1508116708
Name:SEEBER, MICHELE (MA, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:SEEBER
Suffix:
Gender:F
Credentials:MA, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2889 FARGO RD
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-8208
Mailing Address - Country:US
Mailing Address - Phone:315-638-2456
Mailing Address - Fax:
Practice Address - Street 1:2889 FARGO RD
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-8208
Practice Address - Country:US
Practice Address - Phone:315-638-2456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011697235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist