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850 S Hewitt Rd Ste 100 Ypsilanti MI 48197-4594 | |
| (734) 544-5561 | |
| (734) 527-5981 |
| Full Name | |
|---|---|
| Speciality | Speech-Language Pathologist |
| Location | 850 S Hewitt Rd Ste 100, Ypsilanti, Michigan |
| Authorized Official Name and Position | Philip Menard (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7346571470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
850 S Hewitt Rd Ste 100 Ypsilanti MI 48197-4594 Ph: (734) 544-5561 | 850 S Hewitt Rd Ste 100 Ypsilanti MI 48197-4594 Ph: (734) 544-5561 |
| NPI Number | 1578138277 |
|---|---|
| Provider Enumeration Date | 05/25/2021 |
| Last Update Date | 05/01/2023 |
| Certification Date | 05/01/2023 |
| Medicare PECOS PAC ID | 7315340304 |
|---|---|
| Medicare Enrollment ID | O20210728002841 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578138277 | NPI | - | NPPES |
| Provider Name | Reema Shah |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1528678570 PECOS PAC ID: 3971922683 Enrollment ID: I20200930000819 |
| Provider Name | Celeste N Krawchuck |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063053940 PECOS PAC ID: 2769885474 Enrollment ID: I20210719002248 |
| Provider Name | Kelsey Honsberger |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912633066 PECOS PAC ID: 5890178487 Enrollment ID: I20220815001561 |
| Provider Name | Amanda Rose Jager |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1265107122 PECOS PAC ID: 5597125203 Enrollment ID: I20230713001059 |
| Provider Name | Darcie Ann Shaw |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548046741 PECOS PAC ID: 9830532175 Enrollment ID: I20240203000228 |
| Provider Name | Megan Wilcoxon |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1215797071 PECOS PAC ID: 8325485345 Enrollment ID: I20240326000831 |
| Provider Name | Erin M Hacker |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1811744246 PECOS PAC ID: 6406297910 Enrollment ID: I20240515002509 |
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