Provider Demographics
NPI:1932221264
Name:PALMER, MICHELLE L (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:PALMER
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 1:801 N FEDERAL ST APT 1054
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-6320
Mailing Address - Country:US
Mailing Address - Phone:480-634-1226
Mailing Address - Fax:
Practice Address - Street 1:2040 S. ALMA SCHOOL RD
Practice Address - Street 2:SUITE 1, PMB 500
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248
Practice Address - Country:US
Practice Address - Phone:602-445-9337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP4813235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist