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General NPI Number Information
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NPI Number | 1114642089
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Entity Type | Individual
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Provider Name | MICHELLE NAYBERG M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 11 PLAZA REAL S APT 917
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City | BOCA RATON
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State | FL
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Zip | 33432-4898
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Country | US
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Telephone | 267-528-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 176 GLENIFFER HILL RD
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City | RICHBORO
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State | PA
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Zip | 18954-1367
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Country | US
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Telephone | 267-528-8600
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Fax |
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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 | SL016650
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA21961
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License Number State | FL
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