Provider Demographics
NPI:1649337940
Name:D'AMICO, MICHELLE ELIZABETH (MA CCC-A)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:D'AMICO
Suffix:
Gender:F
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 1:7 TUXEDO CT
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-5602
Mailing Address - Country:US
Mailing Address - Phone:956-983-0994
Mailing Address - Fax:
Practice Address - Street 1:1797 SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2136
Practice Address - Country:US
Practice Address - Phone:856-424-0414
Practice Address - Fax:856-424-6335
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00086900237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter