Provider Demographics
NPI:1790800522
Name:RAFF, MICHAEL J (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:RAFF
Suffix:
Gender:M
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 NOLANA AVE
Mailing Address - Street 2:SUITE 1-W
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504
Mailing Address - Country:US
Mailing Address - Phone:956-630-4327
Mailing Address - Fax:956-630-4461
Practice Address - Street 1:309 W NOLANA ST
Practice Address - Street 2:SUITE 1-W
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2583
Practice Address - Country:US
Practice Address - Phone:956-630-4327
Practice Address - Fax:956-630-4461
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50249237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter