Provider Demographics
NPI:1982894788
Name:TRETTER, MICHELE ANTOINETTE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:ANTOINETTE
Last Name:TRETTER
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 1:112 HOLLAND LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4577
Mailing Address - Country:US
Mailing Address - Phone:501-868-7726
Mailing Address - Fax:
Practice Address - Street 1:112 HOLLAND LN
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-4577
Practice Address - Country:US
Practice Address - Phone:501-868-7726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1525235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist