Provider Demographics
NPI:1497181770
Name:LINGLER, MICHELE ANNETTE (PC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANNETTE
Last Name:LINGLER
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6522 OLD ROUTE 39 NW
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-7792
Mailing Address - Country:US
Mailing Address - Phone:330-340-1735
Mailing Address - Fax:
Practice Address - Street 1:1402 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-2880
Practice Address - Country:US
Practice Address - Phone:330-340-1735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1200283101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional