Provider Demographics
NPI:1851542385
Name:MOBBS, MICHELLE DULAY (CDMS)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DULAY
Last Name:MOBBS
Suffix:
Gender:F
Credentials:CDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1948
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77487-1948
Mailing Address - Country:US
Mailing Address - Phone:832-545-5505
Mailing Address - Fax:832-550-2585
Practice Address - Street 1:14100 SOUTHWEST FWY
Practice Address - Street 2:360
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3466
Practice Address - Country:US
Practice Address - Phone:281-277-0085
Practice Address - Fax:832-550-2585
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00055451171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator