Provider Demographics
NPI:1790802379
Name:SOBLE-LERNOR, MICHELLE JOY (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JOY
Last Name:SOBLE-LERNOR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6922 E WETHERSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5361
Mailing Address - Country:US
Mailing Address - Phone:602-770-7449
Mailing Address - Fax:
Practice Address - Street 1:3206 TOWER OAKS BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4254
Practice Address - Country:US
Practice Address - Phone:602-770-7449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist