Doctor Name: | MRS. MICHELLE GROSS |
NPI Number: | 1831217058 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | SP6770 |
Business Practice Address: | 164 W Hospitality Ln San Bernardino, CA - 924083316 |
Business Phone Number: | 9093791525 |
Business Fax Number: | 9093791517 |
Mailing Address: | 7285 Greylock Ave, RIVERSIDE |
State: | CA |
Postal Code: | 925044920 |
Phone Number: | 9516405068 |
Fax Number: | 9517803235 |
NPI Enumeration Date: | 03/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP6770 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |