Provider Demographics
NPI:1801593983
Name:SOYANGCO, MICHELLE MEMPIN (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MEMPIN
Last Name:SOYANGCO
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 SALEM END RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-2417
Mailing Address - Country:US
Mailing Address - Phone:626-622-7314
Mailing Address - Fax:
Practice Address - Street 1:171 SALEM END RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-2417
Practice Address - Country:US
Practice Address - Phone:626-622-7314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4831224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant