Provider Demographics
NPI:1356417315
Name:SHLEYFER, MICHAEL (MA CCC-A)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:SHLEYFER
Suffix:
Gender:M
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 ZELZAH AVE APT 19
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2125
Mailing Address - Country:US
Mailing Address - Phone:818-343-4368
Mailing Address - Fax:
Practice Address - Street 1:6229 W 87TH ST
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:CA
Practice Address - Zip Code:90045-3901
Practice Address - Country:US
Practice Address - Phone:310-677-1168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2453231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist