Provider Demographics
NPI:1548707714
Name:TORRES, MICHELLE SUZANNE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:SUZANNE
Last Name:TORRES
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 1:1101 CENTRAL EXPY S
Mailing Address - Street 2:SUITE 185
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8131
Mailing Address - Country:US
Mailing Address - Phone:214-509-6961
Mailing Address - Fax:214-382-0943
Practice Address - Street 1:1101 CENTRAL EXPY S
Practice Address - Street 2:SUITE 185
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8131
Practice Address - Country:US
Practice Address - Phone:214-509-6961
Practice Address - Fax:214-382-0943
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111226235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist