Elise Decker

Individual provider Active NPI Speech-Language Pathologist · Houghton Lake, MI

NPI 1073155016 · NPPES record last updated Oct 10, 2019

Key facts

NPI
1073155016
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
2280 Tower Hill Rd
Houghton Lake, MI 48629-8961
Phone
(989) 422-5153
NPI assigned
Oct 10, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Yes

Addresses

Primary practice location

2280 Tower Hill Rd
Houghton Lake, MI 48629-8961

Mailing address

3049 Wausaukee Dr NE
Grand Rapids, MI 49525-1916

Other providers in Houghton Lake, MI

All providers in Houghton Lake, MI · Speech-Language Pathologist in Michigan

Sources for this page

Verify at the official NPI Registry.