Provider Demographics
NPI:1063030443
Name:YARGEAU, MICHELLE (PT, DPT, CWS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:YARGEAU
Suffix:
Gender:F
Credentials:PT, DPT, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 IRIS LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7513
Mailing Address - Country:US
Mailing Address - Phone:413-364-4801
Mailing Address - Fax:
Practice Address - Street 1:10 IRIS LN
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7513
Practice Address - Country:US
Practice Address - Phone:413-364-4801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-11
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0134134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist