Provider Demographics
NPI:1952871642
Name:ANDRON, MICHELLE SUZANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:SUZANNE
Last Name:ANDRON
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 1:30 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-1226
Mailing Address - Country:US
Mailing Address - Phone:973-897-7539
Mailing Address - Fax:
Practice Address - Street 1:30 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1226
Practice Address - Country:US
Practice Address - Phone:973-897-7539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00948700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist