| Doctor Name: | MICHELLE MINTZ |
| NPI Number: | 1588893481 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S.,C.C.C.-SLP |
| License Number: | SP 9857 |
| Business Practice Address: | 1537 Berkeley St #7 Santa Monica, CA - 904043224 |
| Business Phone Number: | 3109025008 |
| Business Fax Number: | |
| Mailing Address: | 1537 Berkeley St, #7 SANTA MONICA |
| State: | CA |
| Postal Code: | 904043224 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/13/2009 |
| NPI Last Update Date: | 03/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP 9857 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| 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 |