Individual
MRS. MICHELE THERESE PULVERMACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
1772 STIEGER LAKE LANE, VICTORIA, MN 55386
(952) 443-9888
(952) 443-9804
Mailing address
PO BOX 34, VICTORIA, MN 55386
(952) 443-9888
(952) 443-9804
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6097
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4600498
MEDICA
—
01
—
80B68PU
BCBS MN
—
01
—
HP32573
HEALTH PARTNERS
—
Enumeration date
09/08/2006
Last updated
07/08/2007
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