Provider Demographics
NPI:1447483912
Name:HOBBS, MICHELLE LADONNA (SLP MA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LADONNA
Last Name:HOBBS
Suffix:
Gender:F
Credentials:SLP MA
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LADONNA
Other - Last Name:HERTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP MA
Mailing Address - Street 1:1301 N A W GRIMES BLVD APT 537
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-3465
Mailing Address - Country:US
Mailing Address - Phone:815-260-0385
Mailing Address - Fax:
Practice Address - Street 1:1102 WINKLER AVE
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-6249
Practice Address - Country:US
Practice Address - Phone:254-634-8505
Practice Address - Fax:254-519-3477
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105332235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist