Michele Therese Jones, LICENSED NEW YORK ST

Individual provider Active NPI Speech-Language Pathologist · Mayville, NY

NPI 1144598129 · NPPES record last updated Dec 8, 2011

Key facts

NPI
1144598129
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
#007556-1 (NY)
Practice address
100 North Erie Street
Chautauqua Lake Central School-Erie 2 Boces Program
Mayville, NY 14757
Phone
(716) 753-5843
Fax
(716) 753-5850
NPI assigned
Dec 6, 2011
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

State licenses

LicenseStateTypeSpecialty
#007556-1NYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X #007556-1 NY Yes

Addresses

Primary practice location

100 North Erie Street
Chautauqua Lake Central School-Erie 2 Boces Program
Mayville, NY 14757

Mailing address

8685 Erie Road
Erie 2-Chautauqua-Cattaraugus Boces-Carrier Center
Angola, NY 14006
Phone (716) 549-4454

Other providers in Mayville, NY

All providers in Mayville, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.