Provider Demographics
NPI:1174965065
Name:CAVERO, MICHELLE E (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:E
Last Name:CAVERO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:LOWRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:45 N KING ST
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1001
Mailing Address - Country:US
Mailing Address - Phone:516-220-6078
Mailing Address - Fax:
Practice Address - Street 1:45 N KING ST
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-1001
Practice Address - Country:US
Practice Address - Phone:516-220-6078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00797300235Z00000X
NY024444235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist