MEDICARE: MRS. MICHELE R SILVA M.S., CCC/SLP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	000-858-1	NY

General Provider Information

NPI Number	:	1205110939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELE R SILVA M.S., CCC/SLP

Provider Business Mailing Address
First Line	:	PO BOX 200
Second Line	:	HADLEY-LUZERNE CENTRAL SCHOOL
City	:	LAKE LUZERNE
State	:	NY
Zip	:	12846-0200
Country	:	US
Telephone Number	:	518-696-2378
Fax Number	:	518-696-2485

Provider Business Practice Location Address
First Line	:	27 HYLAND DRIVE
Second Line	:	STUART M. TOWNSEND MIDDLE SCHOOL
City	:	LAKE LUZERNE
State	:	NY
Zip	:	12846-0200
Country	:	US
Telephone Number	:	518-696-2378
Fax Number	:	518-696-2485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2011
Last Update Date	:	09/29/2011

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Directions to “ MRS. MICHELE R SILVA M.S., CCC/SLP” Practice Location

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