Provider Demographics
NPI:1588223317
Name:GAMEZ, MICHAELA
Entity Type:Individual
Prefix:MRS
First Name:MICHAELA
Middle Name:
Last Name:GAMEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MICHAELA
Other - Middle Name:
Other - Last Name:REECE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:830 BETHANY CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-8106
Mailing Address - Country:US
Mailing Address - Phone:828-245-2852
Mailing Address - Fax:
Practice Address - Street 1:830 BETHANY CHURCH RD
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-8106
Practice Address - Country:US
Practice Address - Phone:828-245-2852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2003101235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist