Provider Demographics
NPI:1043440555
Name:BODE, MICHELLE L (AUD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:L
Last Name:BODE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:LEVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8000 YORK RD
Mailing Address - Street 2:TOWSON UNIVERSITY, IWB
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21252-0001
Mailing Address - Country:US
Mailing Address - Phone:410-704-7300
Mailing Address - Fax:410-704-6303
Practice Address - Street 1:8000 YORK RD
Practice Address - Street 2:TOWSON UNIVERSITY, IWB
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21252-0001
Practice Address - Country:US
Practice Address - Phone:410-704-7300
Practice Address - Fax:410-704-6303
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01220231H00000X
TX80160231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter