MEDICARE: MICHELLE LYNN THERAPY PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1033729603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHELLE LYNN THERAPY PLC

Provider Business Mailing Address
First Line	:	1691 E US 23 STE 4
Second Line	:
City	:	EAST TAWAS
State	:	MI
Zip	:	48730-9337
Country	:	US
Telephone Number	:	989-479-7550
Fax Number	:	989-702-2260

Provider Business Practice Location Address
First Line	:	1691 E US 23 STE 4
Second Line	:
City	:	EAST TAWAS
State	:	MI
Zip	:	48730-9337
Country	:	US
Telephone Number	:	989-310-1962
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SPEECH-LANGUAGE THERAPIST
Name	:	MICHELLE LYNN ST. AUBIN
Credential	:	MS CCC-SLP
Telephone Number	:	989-310-1962

Provider Enumeration Date	:	08/07/2020
Last Update Date	:	05/26/2022

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