Provider Demographics
NPI:1245667484
Name:DECK, MICHELLE (MA, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:DECK
Suffix:
Gender:
Credentials:MA, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 65TH ST APT 11A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6652
Mailing Address - Country:US
Mailing Address - Phone:516-655-2660
Mailing Address - Fax:
Practice Address - Street 1:160 E 65TH ST APT 11A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6652
Practice Address - Country:US
Practice Address - Phone:516-655-2660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist