Provider Demographics
NPI:1477821593
Name:GIRARD, MICHELLE ELIZABETH (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:GIRARD
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 1:10608 AQUILLA TRL
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-5843
Mailing Address - Country:US
Mailing Address - Phone:254-366-9485
Mailing Address - Fax:
Practice Address - Street 1:900 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701
Practice Address - Country:US
Practice Address - Phone:254-296-9792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-03
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24742235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist