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General NPI Number Information
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NPI Number | 1114632049
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Entity Type | Individual
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Provider Name | PATRICIA MASELLO M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 91 MINGES RD N
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City | BATTLE CREEK
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State | MI
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Zip | 49015-7909
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Country | US
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Telephone | 269-380-7588
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Fax | 269-294-0612
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Provider Business Mailing Address
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Address Line | 5420 BECKLEY RD # 255
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City | BATTLE CREEK
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State | MI
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Zip | 49015-5719
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Country | US
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Telephone | 269-380-7588
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Fax | 269-294-0612
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 7101007341
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License Number State | MI
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