Provider Demographics
NPI:1841754777
Name:PRICE, MICHELLE (SHELLY) E
Entity Type:Individual
Prefix:
First Name:MICHELLE (SHELLY)
Middle Name:E
Last Name:PRICE
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 1:2335 S 225 E
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:47394-8771
Mailing Address - Country:US
Mailing Address - Phone:937-417-4950
Mailing Address - Fax:
Practice Address - Street 1:2335 S 225 E
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:IN
Practice Address - Zip Code:47394-8771
Practice Address - Country:US
Practice Address - Phone:937-417-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health