Provider Demographics
NPI:1558480038
Name:CLELAND, MICHELE TRIPP (MS, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:TRIPP
Last Name:CLELAND
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 NEW LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5457
Mailing Address - Country:US
Mailing Address - Phone:252-633-1340
Mailing Address - Fax:
Practice Address - Street 1:2842 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2839
Practice Address - Country:US
Practice Address - Phone:252-514-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1781231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist