Provider Demographics
NPI:1346391166
Name:NORMAN, MICHELE L (PHD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:L
Last Name:NORMAN
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 ABBEYDALE CT
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-7121
Mailing Address - Country:US
Mailing Address - Phone:804-796-9078
Mailing Address - Fax:
Practice Address - Street 1:2907 ABBEYDALE CT
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-7121
Practice Address - Country:US
Practice Address - Phone:804-796-9078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002997235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist