Provider Demographics
NPI:1720270259
Name:TEJADA, MICHELLE LYNN (AUD, CCC/A)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LYNN
Last Name:TEJADA
Suffix:
Gender:F
Credentials:AUD, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5145 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2327
Mailing Address - Country:US
Mailing Address - Phone:520-232-7039
Mailing Address - Fax:520-232-7002
Practice Address - Street 1:5145 E 5TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2327
Practice Address - Country:US
Practice Address - Phone:520-232-7039
Practice Address - Fax:520-232-7002
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA13005231H00000X
TX51008231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter