Provider Demographics
NPI:1407731912
Name:MCCOLLEY SPEECH AND LANGUAGE SERVICES OF GREATER MICHIGAN PLLC
Entity type:Organization
Organization Name:MCCOLLEY SPEECH AND LANGUAGE SERVICES OF GREATER MICHIGAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH PATHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-708-8921
Mailing Address - Street 1:1942 BRIDLE CREEK ST SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4939
Mailing Address - Country:US
Mailing Address - Phone:602-708-8921
Mailing Address - Fax:
Practice Address - Street 1:1942 BRIDLE CREEK ST SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4939
Practice Address - Country:US
Practice Address - Phone:602-708-8921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty