Provider Demographics
NPI:1114428661
Name:BURNS, MICHELLE RHEA (COTA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RHEA
Last Name:BURNS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 REDBUD TRAIL LN
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-2055
Mailing Address - Country:US
Mailing Address - Phone:281-543-3568
Mailing Address - Fax:
Practice Address - Street 1:2607 REDBUD TRAIL LN
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-2055
Practice Address - Country:US
Practice Address - Phone:281-543-3568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant