Provider Demographics
NPI:1659098739
Name:MICHIGAN SPEECH PATHOLOGY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:MICHIGAN SPEECH PATHOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-339-6049
Mailing Address - Street 1:1557 GLASS LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-3736
Mailing Address - Country:US
Mailing Address - Phone:248-339-6049
Mailing Address - Fax:248-702-4392
Practice Address - Street 1:1557 GLASS LAKE CIR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-3736
Practice Address - Country:US
Practice Address - Phone:248-339-6049
Practice Address - Fax:248-702-4392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty