Provider Demographics
NPI:1255329934
Name:CAMARATA, MICHELLE LOUISE (MHA MDT PT)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LOUISE
Last Name:CAMARATA
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Gender:F
Credentials:MHA MDT PT
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Mailing Address - Street 1:20347 TIMBERLAKE RD
Mailing Address - Street 2:STE B
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7352
Mailing Address - Country:US
Mailing Address - Phone:434-385-8359
Mailing Address - Fax:434-385-8324
Practice Address - Street 1:118 OAKWOOD DR
Practice Address - Street 2:STE B
Practice Address - City:MADISON HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:24572-3001
Practice Address - Country:US
Practice Address - Phone:434-385-8359
Practice Address - Fax:434-385-8324
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2023-10-04
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Provider Licenses
StateLicense IDTaxonomies
CT4225225100000X
VA2305206791225100000X
GAPT002364225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT080004225CT07OtherBLUE CROSS BLUE SHIELD
CT5563079OtherAETNA
VA1255329934OtherNPI