Michele Ann Charland, MS CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Prospect, CT

NPI 1871827485 · NPPES record last updated Sep 29, 2009

Key facts

NPI
1871827485
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
003665 (CT)
Practice address
4 Summit Rd Ste C
Prospect, CT 06712-1485
Phone
(203) 758-0755
Fax
(203) 758-0754
NPI assigned
Sep 29, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
003665CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Full Spectrum Therapeutics LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 003665 CT Yes

Addresses

Primary practice location

4 Summit Rd Ste C
Prospect, CT 06712-1485

Mailing address

4 Summit Rd Ste C
Prospect, CT 06712-1485
Phone (203) 758-0755

Other providers in Prospect, CT

All providers in Prospect, CT · Speech-Language Pathologist in Connecticut

Sources for this page

Verify at the official NPI Registry.