Provider Demographics
NPI:1679016828
Name:MCCLAFFERTY-HELLEY, MICHELLE ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:MCCLAFFERTY-HELLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 AUTO CENTER DR
Mailing Address - Street 2:#D
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4493
Mailing Address - Country:US
Mailing Address - Phone:661-945-7878
Mailing Address - Fax:661-945-7553
Practice Address - Street 1:861 AUTO CENTER DR
Practice Address - Street 2:#D
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4493
Practice Address - Country:US
Practice Address - Phone:661-945-7878
Practice Address - Fax:661-945-7553
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16650225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist