Provider Demographics
NPI:1407404825
Name:RAWLINGS, MICHELLE LEE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEE
Last Name:RAWLINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LEE
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1836 SHIREWICK DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5359
Mailing Address - Country:US
Mailing Address - Phone:702-595-9141
Mailing Address - Fax:
Practice Address - Street 1:1836 SHIREWICK DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5359
Practice Address - Country:US
Practice Address - Phone:702-595-9141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health