Provider Demographics
NPI:1811457153
Name:ALBANESE, MICHELLE BIANCA (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:BIANCA
Last Name:ALBANESE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10519 YELLOW ROSE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5159
Mailing Address - Country:US
Mailing Address - Phone:848-459-8150
Mailing Address - Fax:
Practice Address - Street 1:197 PIEDMONT BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1846
Practice Address - Country:US
Practice Address - Phone:803-639-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12328235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist