Provider Demographics
NPI:1518242916
Name:DURRANT, MICHELLE ELIZABETH (AUD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:DURRANT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:755 BOARDMAN CANFIELD RD
Mailing Address - Street 2:STE C1
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4387
Mailing Address - Country:US
Mailing Address - Phone:330-726-8155
Mailing Address - Fax:330-726-8612
Practice Address - Street 1:755 BOARDMAN CANFIELD RD
Practice Address - Street 2:SUITE C1 WEST
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4300
Practice Address - Country:US
Practice Address - Phone:330-726-8155
Practice Address - Fax:330-726-8612
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231HA2400X, 231HA2500X, 231H00000X
OHA02008237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
H460850Medicare UPIN