Doctor Name: | MRS. MICHELE THERESE PULVERMACHER |
NPI Number: | 1629172986 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC SLP |
License Number: | 6097 |
Business Practice Address: | 1772 Stieger Lake Lane Victoria, MN - 55386 |
Business Phone Number: | 9524439888 |
Business Fax Number: | 9524439804 |
Mailing Address: | Po Box 34, VICTORIA |
State: | MN |
Postal Code: | 55386 |
Phone Number: | 9524439888 |
Fax Number: | 9524439804 |
NPI Enumeration Date: | 09/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 6097 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
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 |