Provider Demographics
NPI:1164793329
Name:ENGLE, MICHELE L (MS, OTR)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:L
Last Name:ENGLE
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8804 SUZANNE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46234-9505
Mailing Address - Country:US
Mailing Address - Phone:317-271-7401
Mailing Address - Fax:
Practice Address - Street 1:501 S MURPHY AVE
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-8316
Practice Address - Country:US
Practice Address - Phone:812-442-0403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002754A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist