Provider Demographics
NPI:1750505103
Name:NEUMANN, MICHELLE (FP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:NEUMANN
Suffix:
Gender:F
Credentials:FP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 N 177TH AVE
Mailing Address - Street 2:
Mailing Address - City:WADDELL
Mailing Address - State:AZ
Mailing Address - Zip Code:85355-9381
Mailing Address - Country:US
Mailing Address - Phone:623-535-8063
Mailing Address - Fax:
Practice Address - Street 1:7701 N 177TH AVE
Practice Address - Street 2:
Practice Address - City:WADDELL
Practice Address - State:AZ
Practice Address - Zip Code:85355-9381
Practice Address - Country:US
Practice Address - Phone:623-535-8063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ083919Medicaid