MEDICARE: MICHELLE VANO SLP-CCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1285000844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE VANO SLP-CCC

Provider Business Mailing Address
First Line	:	3360 MORNING GLORY ROAD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19154-3030
Country	:	US
Telephone Number	:	917-651-8453
Fax Number	:

Provider Business Practice Location Address
First Line	:	3360 MORNING GLORY RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19154-1820
Country	:	US
Telephone Number	:	917-651-8453
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2015
Last Update Date	:	02/14/2017

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Directions to “ MICHELLE VANO SLP-CCC” Practice Location

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