Provider Demographics
NPI:1003218454
Name:WARNER, MICHELLE LYNN (CMT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:WARNER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N WIGET LN
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2435
Mailing Address - Country:US
Mailing Address - Phone:925-935-5425
Mailing Address - Fax:
Practice Address - Street 1:325 N WIGET LN
Practice Address - Street 2:SUITE 130
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2435
Practice Address - Country:US
Practice Address - Phone:925-935-5425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist