Provider Demographics
NPI:1215187331
Name:O'CONNOR, MICHELLE DENISE (OTR/L,CHT)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:DENISE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:OTR/L,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 SAN RAMON VALLEY BLVD
Mailing Address - Street 2:100
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526
Mailing Address - Country:US
Mailing Address - Phone:925-743-8905
Mailing Address - Fax:925-743-9614
Practice Address - Street 1:760 SAN RAMON VALLEY BLVD
Practice Address - Street 2:100
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4056
Practice Address - Country:US
Practice Address - Phone:925-743-8905
Practice Address - Fax:925-743-9614
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3075174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist