Provider Demographics
NPI:1619203593
Name:MICHENER, GEORGIANN JEAN (BCHIS ACA)
Entity Type:Individual
Prefix:MRS
First Name:GEORGIANN
Middle Name:JEAN
Last Name:MICHENER
Suffix:
Gender:F
Credentials:BCHIS ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 HOLLYWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-2703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5126 STATE ROUTE 30
Practice Address - Street 2:SUITE 330
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7835
Practice Address - Country:US
Practice Address - Phone:724-836-4327
Practice Address - Fax:724-836-1803
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFO2955237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist