Provider Demographics
NPI:1245241488
Name:MOBLEY, MICHELLE F
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:F
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 PEMBERTON HILL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3957
Mailing Address - Country:US
Mailing Address - Phone:919-434-6398
Mailing Address - Fax:919-557-2089
Practice Address - Street 1:1101 PEMBERTON HILL RD STE 103
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502
Practice Address - Country:US
Practice Address - Phone:919-434-6398
Practice Address - Fax:919-557-2089
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0053361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical