Provider Demographics
NPI:1780862433
Name:VANDO, MICHELE LYNNE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:LYNNE
Last Name:VANDO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 BEAR PATH LN
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-6402
Mailing Address - Country:US
Mailing Address - Phone:603-889-5650
Mailing Address - Fax:
Practice Address - Street 1:203 LOWELL RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4909
Practice Address - Country:US
Practice Address - Phone:603-882-5261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1025235Z00000X
MA6249235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist