MEDICARE: MS. MICHELLE MARIE FERRELL CCC-SLP

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	SA15591	FL
2	235Z00000X	Speech-Language Pathologist	3944	CO

General Provider Information

NPI Number	:	1710175492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE MARIE FERRELL CCC-SLP

Provider Business Mailing Address
First Line	:	2004 N 12TH ST
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-2982
Country	:	US
Telephone Number	:	970-644-3720
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 N 12TH ST
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-2982
Country	:	US
Telephone Number	:	970-644-3720
Fax Number	:

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

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	06/14/2021

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