Provider Demographics
NPI:1952614224
Name:LAYMAN, MICHELLE LYNN (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LYNN
Last Name:LAYMAN
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 S BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-3528
Mailing Address - Country:US
Mailing Address - Phone:765-661-7373
Mailing Address - Fax:844-965-9877
Practice Address - Street 1:302 S BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-3528
Practice Address - Country:US
Practice Address - Phone:765-661-7373
Practice Address - Fax:844-965-9877
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003321A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200603960Medicaid