Provider Demographics
NPI:1366029878
Name:FERRARO, MICHELLE LEANN (LPTA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEANN
Last Name:FERRARO
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 YORKSHIRE TRL
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-8872
Mailing Address - Country:US
Mailing Address - Phone:757-667-9450
Mailing Address - Fax:
Practice Address - Street 1:820 YORKSHIRE TRL
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-8872
Practice Address - Country:US
Practice Address - Phone:757-667-9450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA225200000X
VA2306602896225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant