Provider Demographics
NPI:1285965202
Name:HUXEL, MICHELLE RENE
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:RENE
Last Name:HUXEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 W. KORTSEN RD.
Mailing Address - Street 2:CASA GRANDE ELEMENTARY SCHOOL DISTRICT
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5910
Mailing Address - Country:US
Mailing Address - Phone:520-876-3244
Mailing Address - Fax:
Practice Address - Street 1:220 W. KORTSEN RD.
Practice Address - Street 2:CASA GRANDE ELEMENTARY SCHOOL DISTRICT
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5910
Practice Address - Country:US
Practice Address - Phone:520-876-3244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA63352355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant