Provider Demographics
NPI:1619161304
Name:HILLEY, MICHELE SUSAN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:SUSAN
Last Name:HILLEY
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 1:70 MOUNT VERNON ST
Mailing Address - Street 2:APT. 2B
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-1340
Mailing Address - Country:US
Mailing Address - Phone:617-723-0446
Mailing Address - Fax:
Practice Address - Street 1:70 MOUNT VERNON ST
Practice Address - Street 2:APT. 2B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-1340
Practice Address - Country:US
Practice Address - Phone:617-723-0446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5061235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist