Provider Demographics
NPI:1952559973
Name:KIRKPATRICK, MICHELLE DENISE (MS, CFY-SLP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DENISE
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 N MISSION PARK BLVD
Mailing Address - Street 2:APT 1008
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3988
Mailing Address - Country:US
Mailing Address - Phone:480-282-2112
Mailing Address - Fax:
Practice Address - Street 1:3341 E QUEEN CREEK RD
Practice Address - Street 2:SUITE 109
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-8503
Practice Address - Country:US
Practice Address - Phone:480-621-8361
Practice Address - Fax:480-621-8513
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP5986235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist