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General NPI Number Information
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NPI Number | 1003546821
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Entity Type | Organization
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Legal Business Name | NORTH 42 DEGREES THERAPY PLLC
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 42842 LOMBARDY DR
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City | CANTON
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State | MI
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Zip | 48187-2321
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Country | US
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Telephone | 734-361-9804
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Fax | 734-353-4300
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Provider Business Mailing Address
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Address Line | 42842 LOMBARDY DR
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City | CANTON
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State | MI
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Zip | 48187-2321
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Country | US
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Telephone | 734-436-1980
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Fax | 734-353-4300
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Authorized Official
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Title or Position | SPEECH AND LANGUAGE PATHOLOGIST
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Name | MRS. JUILE ELLIOTT
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Credential | M.A. CCC-SLP
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Telephone | 734-436-1980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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