Provider Demographics
NPI:1912980871
Name:MICHAEL, PATRICIA ANN (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:MICHAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, CCC-SLP
Mailing Address - Street 1:U.T. HEARING AND SPEECH CENTER
Mailing Address - Street 2:1600 PEYTON MANNING PASS
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-0001
Mailing Address - Country:US
Mailing Address - Phone:865-974-5451
Mailing Address - Fax:865-974-4639
Practice Address - Street 1:U.T. HEARING AND SPEECH CENTER
Practice Address - Street 2:1600 PEYTON MANNING PASS
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-0001
Practice Address - Country:US
Practice Address - Phone:865-974-5451
Practice Address - Fax:865-974-4639
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002843235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3713026Medicare PIN