Provider Demographics
NPI:1508426040
Name:ALLEN, MICHELE SHARON (CCC-A)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:SHARON
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 FARMHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1324
Mailing Address - Country:US
Mailing Address - Phone:410-491-2454
Mailing Address - Fax:
Practice Address - Street 1:2011 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-4430
Practice Address - Country:US
Practice Address - Phone:410-491-2454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist