Healthcare Provider Details

I. General information

NPI: 1306996392
Provider Name (Legal Business Name): MICHELE NOTTE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 CENTRAL AVE THOMPSON HALL
FREDONIA NY
14063-1127
US

IV. Provider business mailing address

758 WASHINGTON AVE
DUNKIRK NY
14048-2509
US

V. Phone/Fax

Practice location:
  • Phone: 716-673-3203
  • Fax: 716-673-3235
Mailing address:
  • Phone: 716-366-3753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number000960-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: