Provider Demographics
NPI:1689068744
Name:GEE, MICHELLE LYNN (MSSA, LWS)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LYNN
Last Name:GEE
Suffix:
Gender:F
Credentials:MSSA, LWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 STATE HWY 108, SUITE A
Mailing Address - Street 2:
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567
Mailing Address - Country:US
Mailing Address - Phone:419-335-3732
Mailing Address - Fax:419-335-3462
Practice Address - Street 1:1425 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506
Practice Address - Country:US
Practice Address - Phone:419-335-3732
Practice Address - Fax:419-335-3462
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1100479101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health