Provider Demographics
NPI:1932508074
Name:KIRKPATRICK, MICHELLE DANETTE (MS, SLP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DANETTE
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:DANETTE
Other - Last Name:DOTRAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, SLP
Mailing Address - Street 1:16 COURTSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7803
Mailing Address - Country:US
Mailing Address - Phone:956-455-0027
Mailing Address - Fax:
Practice Address - Street 1:16 COURTSIDE CIR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7803
Practice Address - Country:US
Practice Address - Phone:956-455-0027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist