| Doctor Name: | MICHELLE SUSAN BASALYGA |
| NPI Number: | 1457492050 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA CCC-SLP |
| License Number: | SL002711L |
| Business Practice Address: | 242 Noble Rd Clarks Summit, PA - 184119406 |
| Business Phone Number: | 5705875101 |
| Business Fax Number: | |
| Mailing Address: | 104 Upper Knapp Rd, CLARKS SUMMIT |
| State: | PA |
| Postal Code: | 184112086 |
| Phone Number: | 5705879982 |
| Fax Number: | |
| NPI Enumeration Date: | 02/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SL002711L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |