Provider Demographics
NPI:1902101868
Name:SCZUDLO, MICHELLE SUSAN (MS CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:SUSAN
Last Name:SCZUDLO
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 1:20 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LE ROY
Mailing Address - State:NY
Mailing Address - Zip Code:14482-1509
Mailing Address - Country:US
Mailing Address - Phone:585-233-1159
Mailing Address - Fax:
Practice Address - Street 1:3837 W MAIN STREET RD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-9404
Practice Address - Country:US
Practice Address - Phone:585-344-2580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006863-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist