Provider Demographics
NPI:1497150411
Name:PARENT, MICHELE (PT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:PARENT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18111 PRINCE PHILIP DR
Mailing Address - Street 2:SUITE 125
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1513
Mailing Address - Country:US
Mailing Address - Phone:301-774-0232
Mailing Address - Fax:301-774-7885
Practice Address - Street 1:18111 PRINCE PHILIP DR
Practice Address - Street 2:SUITE 125
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1513
Practice Address - Country:US
Practice Address - Phone:301-774-0232
Practice Address - Fax:301-774-7885
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist