Provider Demographics
NPI:1811106396
Name:WILKERSON, MICHELE LEIGH (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:LEIGH
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:MICHELE
Other - Middle Name:LEIGH
Other - Last Name:HEDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1369 ROBINHOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-2327
Mailing Address - Country:US
Mailing Address - Phone:937-866-2678
Mailing Address - Fax:
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:MIAMI VALLEY HOSPITAL
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-3028
Practice Address - Fax:937-208-4534
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-3339235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist