Provider Demographics
NPI:1811220809
Name:VERRANAULT, MICHELLE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:VERRANAULT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 N. PIEDRAS
Mailing Address - Street 2:VHA
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-0001
Mailing Address - Country:US
Mailing Address - Phone:915-564-6100
Mailing Address - Fax:
Practice Address - Street 1:5001 N. PIEDRAS
Practice Address - Street 2:VHA
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79930
Practice Address - Country:US
Practice Address - Phone:915-564-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical