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NPI Code Detail

MEDICARE: MICHELLE MACGILLIVRAY

MEDICARE:   MICHELLE  MACGILLIVRAY
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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1346926755
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MACGILLIVRAY
Provider Business Mailing Address
First Line : 1311 MAMARONECK AVE STE 140
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-5224
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11100 86TH AVE N
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-4529
Country : US
Telephone Number : 763-755-4275
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2023
Last Update Date : 06/22/2023

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Directions to “ MICHELLE MACGILLIVRAY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.