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Individual

MRS. MICHELLE ANN PILTCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUDIOLOGIST

Contact information

Practice address
106 LYNCH CREEK WY, SUITE 9A, PETALUMA, CA 94954
(707) 762-0103
(707) 762-5174
Mailing address
1310 COMMERCE ST, SUITE B, PETALUMA, CA 94954-1469
(707) 778-7862
(707) 778-0969

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU897
CA
237600000X
Audiologist-Hearing Aid Fitter
HA3511
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AU 897
LICENSE NO.
CA
05
HA0035110
CA
01
HA3511
STATE OF CALIFORNIA HEARING AID LICENSING BOARD
CA
Enumeration date
02/16/2007
Last updated
07/22/2010
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