Provider Demographics
NPI:1982867305
Name:NEWMAN, COLLEEN A (MACCC-A)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:A
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MACCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28300 ORCHARD LAKE RD
Mailing Address - Street 2:ST100
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3704
Mailing Address - Country:US
Mailing Address - Phone:248-737-4030
Mailing Address - Fax:248-737-0636
Practice Address - Street 1:28300 ORCHARD LAKE RD
Practice Address - Street 2:ST100
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3704
Practice Address - Country:US
Practice Address - Phone:248-737-4030
Practice Address - Fax:248-737-0636
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000273231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist