Provider Demographics
NPI:1447488168
Name:WESTFALL, MICHELE DAWN (MS, CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:DAWN
Last Name:WESTFALL
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:KING FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:13081-0024
Mailing Address - Country:US
Mailing Address - Phone:917-439-1059
Mailing Address - Fax:
Practice Address - Street 1:8769 STATE ROUTE 90 N
Practice Address - Street 2:
Practice Address - City:KING FERRY
Practice Address - State:NY
Practice Address - Zip Code:13081-8716
Practice Address - Country:US
Practice Address - Phone:917-439-1059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019922235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist