MEDICARE: MRS. MICHELLE LAUREN BRAND 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	30002268	NC

General Provider Information

NPI Number	:	1912935321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE LAUREN BRAND CCC-SLP

Provider Business Mailing Address
First Line	:	1205 WATERWAY CT
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28411-8816
Country	:	US
Telephone Number	:	847-778-0923
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E SATCHWELL ST
Second Line	:
City	:	BURGAW
State	:	NC
Zip	:	28425-5064
Country	:	US
Telephone Number	:	910-300-6150
Fax Number	:

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	01/05/2026

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Directions to “ MRS. MICHELLE LAUREN BRAND CCC-SLP” Practice Location

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