Provider Demographics
NPI:1679833172
Name:NEFF, MICHELLE (DEPT)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:NEFF
Suffix:
Gender:F
Credentials:DEPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5944 SEVILLE CIR
Mailing Address - Street 2:
Mailing Address - City:ORCHARD LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48324-2949
Mailing Address - Country:US
Mailing Address - Phone:248-762-2683
Mailing Address - Fax:
Practice Address - Street 1:47085 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-2761
Practice Address - Country:US
Practice Address - Phone:586-598-1247
Practice Address - Fax:586-598-1260
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist