Provider Demographics
NPI:1063043842
Name:MAIER, MICHELLE (REEGT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MAIER
Suffix:
Gender:F
Credentials:REEGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 JUSTIN RD STE 200-H
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7193
Mailing Address - Country:US
Mailing Address - Phone:877-944-2111
Mailing Address - Fax:877-492-1768
Practice Address - Street 1:2012 JUSTIN RD STE 200-H
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7193
Practice Address - Country:US
Practice Address - Phone:877-944-2111
Practice Address - Fax:877-492-1768
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG