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General NPI Number Information
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NPI Number | 1912550104
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Entity Type | Individual
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Provider Name | MICHELLE LANDREAU BC-HIS
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Gender | Female
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Dates
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Enumeration Date | 07/17/2019
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Last Update Date | 07/17/2019
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Provider Practice Location Address
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Address Line | 4354 US HIGHWAY 231 SUITE A
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City | WETUMPKA
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State | AL
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Zip | 36092
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Country | US
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Telephone | 334-580-7061
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Fax |
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Provider Business Mailing Address
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Address Line | 4049 US HIGHWAY 231 # 225
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City | WETUMPKA
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State | AL
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Zip | 36093-1217
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Country | US
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Telephone | 334-580-7061
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 4208
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License Number State | AL
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