Provider Demographics
NPI:1912201815
Name:MICHELLE MENKE SPEECH THERAPY
Entity Type:Organization
Organization Name:MICHELLE MENKE SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:MENKE
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:605-261-8456
Mailing Address - Street 1:1105 W KILLARNEY ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3503
Mailing Address - Country:US
Mailing Address - Phone:605-261-8456
Mailing Address - Fax:
Practice Address - Street 1:1105 W KILLARNEY ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3503
Practice Address - Country:US
Practice Address - Phone:605-261-8456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency