Provider Demographics
NPI:1366653180
Name:MICHAUD, YVONNE MICHELLE (MS CCCSLP)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:MICHELLE
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:MS CCCSLP
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:MICHELLE
Other - Last Name:PENNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:469 MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SPRINGVALE
Mailing Address - State:ME
Mailing Address - Zip Code:04083-1870
Mailing Address - Country:US
Mailing Address - Phone:207-324-2888
Mailing Address - Fax:
Practice Address - Street 1:469 MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:SPRINGVALE
Practice Address - State:ME
Practice Address - Zip Code:04083-1870
Practice Address - Country:US
Practice Address - Phone:207-324-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEME265678OtherLICENSURE