Individual
MICHELLE RENEE PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
6301 S MOUNT VISTA DR, TAYLORSVILLE, UT 84129-6348
(801) 386-6495
Mailing address
6301 S MOUNT VISTA DR, TAYLORSVILLE, UT 84129-6348
(801) 386-6495
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7654946-4102
UT
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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