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General NPI Number Information
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NPI Number | 1366563868
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Entity Type | Individual
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Provider Name | KAMMI PORCELLO M.A.
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2799 W GRAND BLVD HENRY FORD HEALTH SYSTEM K-8 AUDIOLOGY
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City | DETROIT
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State | MI
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Zip | 48202-2608
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Country | US
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Telephone | 313-916-1089
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Fax |
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Provider Business Mailing Address
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Address Line | 22111 VIOLET ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48082-1982
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Country | US
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Telephone | 586-899-4017
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1601000106
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 1601000106
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License Number State | MI
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