Provider Demographics
NPI:1063456382
Name:DENN, MICHELLE A (PT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:A
Last Name:DENN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:720 YORKLYN RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8728
Mailing Address - Country:US
Mailing Address - Phone:302-234-2288
Mailing Address - Fax:302-234-2869
Practice Address - Street 1:720 YORKLYN RD
Practice Address - Street 2:SUITE 150
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8728
Practice Address - Country:US
Practice Address - Phone:302-234-2288
Practice Address - Fax:302-234-2869
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10000404225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
5070-0051OtherCAREFIRST
DE2858669000OtherIBC AMERIHEALTH
91138001OtherNCA
DE1000038038Medicaid
DE808524OtherPABS
$$$$$$$$$OtherCHAMPUS
DE1000038038Medicaid
91138001OtherNCA
5070-0051OtherCAREFIRST