Basic Information
| Provider Information | |||||||||
| NPI: | 1811457153 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALBANESE | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | BIANCA | ||||||||
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| Credential: | M.S. CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10519 YELLOW ROSE LN | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282695159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8484598150 | ||||||||
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| Practice Location | |||||||||
| Address1: | 197 PIEDMONT BLVD STE 205 | ||||||||
| Address2: | |||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297321846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8036398066 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2019 | ||||||||
| LastUpdateDate: | 03/22/2019 | ||||||||
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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 | 12328 | NC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.