National Provider Identifier
Mary Michelle Michelsen
Mary Michelle Michelsen is listed in the NPPES registry with a primary specialty of Occupational Therapist in Penfield, NY and a listed phone number of (585) 465-0733.
Profile Overview
- NPI
- 1801451596
- Provider Type
- Individual
- Primary Specialty
- Occupational Therapist
- Enumeration Date
- May 08, 2019
- Last Updated
- September 24, 2020
Practice Location
- 14 Golden Locust Cir
- Penfield, NY 14526-9777
Phone: (585) 465-0733
Specialties
- Occupational Therapist (225X00000X)
Full Record
- NPI
- 1801451596
- Entity Type
- Individual
- Last Name
- Michelsen
- First Name
- Mary
- Middle Name
- Michelle
- Mailing Street Address
- 14 Golden Locust Cir
- Mailing City
- Penfield
- Mailing State
- NY
- Mailing ZIP Code
- 14526-9777
- Mailing Country
- US
- Practice Street Address
- 14 Golden Locust Cir
- Practice City
- Penfield
- Practice State
- NY
- Practice ZIP Code
- 14526-9777
- Practice Country
- US
- Practice Phone
- (585) 465-0733
- Enumeration Date
- May 08, 2019
- Last Updated
- September 24, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- September 24, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Occupational Therapist (225X00000X)
- Other Identifiers
- 05 (NY)