Provider Demographics
NPI:1780083378
Name:PRATT, MICHELE (SLP)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:
Last Name:PRATT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 CONNETT ROAD
Mailing Address - Street 2:
Mailing Address - City:THE PLAINS
Mailing Address - State:OH
Mailing Address - Zip Code:45780
Mailing Address - Country:US
Mailing Address - Phone:740-797-4572
Mailing Address - Fax:740-797-4432
Practice Address - Street 1:90 CONNETT RD
Practice Address - Street 2:
Practice Address - City:THE PLAINS
Practice Address - State:OH
Practice Address - Zip Code:45780-1453
Practice Address - Country:US
Practice Address - Phone:740-797-4572
Practice Address - Fax:740-797-4432
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3613898235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist