Doctor Name: | MICHELLE MARIE KLYM |
NPI Number: | 1003249533 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.S., SLP-A |
License Number: | SLPA8111 |
Business Practice Address: | 20061 E Rittenhouse Rd Queen Creek, AZ - 851429712 |
Business Phone Number: | 4809879700 |
Business Fax Number: | |
Mailing Address: | Po Box 12452, CASA GRANDE |
State: | AZ |
Postal Code: | 851300620 |
Phone Number: | 5204830640 |
Fax Number: | |
NPI Enumeration Date: | 08/20/2013 |
NPI Last Update Date: | 08/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | SLPA8111 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |