Provider Demographics
NPI:1568654309
Name:MORGAN, MICHELE ANN
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 WISSAHICKON AVE
Mailing Address - Street 2:SUITE 126
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4248
Mailing Address - Country:US
Mailing Address - Phone:215-951-0300
Mailing Address - Fax:215-951-3512
Practice Address - Street 1:4700 WISSAHICKON AVE
Practice Address - Street 2:SUITE 126
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4248
Practice Address - Country:US
Practice Address - Phone:215-951-0300
Practice Address - Fax:215-951-3512
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009681225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist