Provider Demographics
NPI:1396942215
Name:BOYER, MICHELE M (MS,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:M
Last Name:BOYER
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 1:171 SADDLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6952
Mailing Address - Country:US
Mailing Address - Phone:860-645-7788
Mailing Address - Fax:
Practice Address - Street 1:1157 HIGHLAND AVE.
Practice Address - Street 2:SUITE 101
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410
Practice Address - Country:US
Practice Address - Phone:203-271-9288
Practice Address - Fax:203-271-9817
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist