Provider Demographics
NPI:1841319761
Name:DINSMORE, MICHELE LEE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:LEE
Last Name:DINSMORE
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 1:122 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2008
Mailing Address - Country:US
Mailing Address - Phone:413-822-3743
Mailing Address - Fax:
Practice Address - Street 1:165 S RIVER RD UNIT F
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6926
Practice Address - Country:US
Practice Address - Phone:603-206-6830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004961235Z00000X
MASLP9235235Z00000X
NH2341235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist