Provider Demographics
NPI:1376319806
Name:MOREL, MICHAEL TIMOTHY
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:TIMOTHY
Last Name:MOREL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 W DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-3079
Mailing Address - Country:US
Mailing Address - Phone:970-305-8642
Mailing Address - Fax:
Practice Address - Street 1:1044 W DRAKE RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-3079
Practice Address - Country:US
Practice Address - Phone:970-305-8642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician