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General NPI Number Information
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NPI Number | 1205230463
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Entity Type | Individual
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Provider Name | MRS. MICHELLE EARNEST
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Gender | Female
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 22 SARASOTA CENTER BLVD
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City | SARASOTA
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State | FL
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Zip | 34240-9770
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Country | US
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Telephone | 941-377-9361
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 RIVERWALK CT
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City | BRADENTON
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State | FL
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Zip | 34208-8052
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Country | US
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Telephone | 817-718-3198
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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 | 104829
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License Number State | TX
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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 | SA17692
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SL013837
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License Number State | PA
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