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NPI Code Detail

MEDICARE: MICHELLE NOVAK CCC-SLP

MEDICARE: MICHELLE NOVAK 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
1235Z00000XSpeech-Language Pathologist6065NC

General Provider Information

NPI Number : 1720544117
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE NOVAK CCC-SLP
Provider Business Mailing Address
First Line : 2704 COURTNEY LN
Second Line :
City : GREENSBORO
State : NC
Zip : 27408-4306
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3701 WADE COBLE DR
Second Line :
City : BURLINGTON
State : NC
Zip : 27215-9743
Country : US
Telephone Number : 336-538-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2019
Last Update Date : 02/11/2019

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Directions to “ MICHELLE NOVAK CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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