Provider Demographics
NPI:1902500564
Name:STONE, MICHELA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MICHELA
Middle Name:
Last Name:STONE
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 1:4 BOND ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-3763
Mailing Address - Country:US
Mailing Address - Phone:508-272-7733
Mailing Address - Fax:
Practice Address - Street 1:14-16 FLETCHER ST STE 1
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2713
Practice Address - Country:US
Practice Address - Phone:978-212-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77332235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist