Provider Demographics
NPI:1659605400
Name:TARICA, MICHELE LYNN (MA,CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:LYNN
Last Name:TARICA
Suffix:
Gender:F
Credentials:MA,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 A EAST 36TH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3364
Mailing Address - Country:US
Mailing Address - Phone:212-889-8575
Mailing Address - Fax:212-889-0565
Practice Address - Street 1:36 A EAST 36TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3364
Practice Address - Country:US
Practice Address - Phone:212-889-8575
Practice Address - Fax:212-889-0565
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000684-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist