Provider Demographics
NPI:1326585977
Name:BIXLER, MICHELLE R
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:R
Last Name:BIXLER
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 1:132 THE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:CENTRE HALL
Mailing Address - State:PA
Mailing Address - Zip Code:16828-9231
Mailing Address - Country:US
Mailing Address - Phone:814-364-2161
Mailing Address - Fax:814-364-9448
Practice Address - Street 1:13193 FERGUSON VALLEY RD
Practice Address - Street 2:
Practice Address - City:YEAGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:17099-9629
Practice Address - Country:US
Practice Address - Phone:717-248-8197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010592101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health