Provider Demographics
NPI:1609037639
Name:SAVAGE, MICHELLE ADELLE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ADELLE
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3138 KOVAL CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-9010
Mailing Address - Country:US
Mailing Address - Phone:407-233-5685
Mailing Address - Fax:
Practice Address - Street 1:3214 HILLSDALE LN
Practice Address - Street 2:APT 736
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7562
Practice Address - Country:US
Practice Address - Phone:407-233-5685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2622106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist