Provider Demographics
NPI:1528267580
Name:DIMARCANTONIO, MICHELE ANN (MS,CCC,SLP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:DIMARCANTONIO
Suffix:
Gender:F
Credentials:MS,CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12006 NEWPORT SHORE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3919
Mailing Address - Country:US
Mailing Address - Phone:281-433-4033
Mailing Address - Fax:281-807-9148
Practice Address - Street 1:12006 NEWPORT SHORE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3919
Practice Address - Country:US
Practice Address - Phone:281-433-4033
Practice Address - Fax:281-807-9148
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100876235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist