Provider Demographics
NPI:1316567985
Name:STARR, MICHAEL (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:STARR
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 N PLEASANT ST RM 220
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01003-9296
Mailing Address - Country:US
Mailing Address - Phone:413-577-4203
Mailing Address - Fax:
Practice Address - Street 1:358 N PLEASANT ST RM 220
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01003-9296
Practice Address - Country:US
Practice Address - Phone:413-577-4203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76582235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist