Most Relevant Information
Provider Data
| NPI Number: | 1003413774 |
| Provider Name: | MIKEAYLA PELLEGRINO |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 7151013295 |
Most Important Dates
| Enumeration Date: | 10/06/2020 |
| Last Updated: | 10/06/2020 |
Provider Practice Location
103 E MANSION ST RICKETSON BUILDING
MARSHALL
MI
49068
Practice Location Phone/Fax
| Phone: | 2697898982 |
| Fax: |
Provider Mailing Location
103 E MANSION ST RICKETSON BUILDING
MARSHALL
MI
49068
Provider Mailing Phone/Fax
| Phone: | 2697898982 |
| Fax: |