Basic Information
| Provider Information | |||||||||
| NPI: | 1578072625 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOERR | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | RENEE | ||||||||
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| Credential: | M.A. CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1485 S HILLOCK TER | ||||||||
| Address2: | |||||||||
| City: | INVERNESS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344523625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175721561 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7350 DAIRY RD | ||||||||
| Address2: | |||||||||
| City: | ZEPHYRHILLS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335401354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8137884300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2017 | ||||||||
| LastUpdateDate: | 09/20/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SZ8253 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.