Provider Demographics
NPI:1891864013
Name:WANGLER, MICHELLE L (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:WANGLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 MAPLE ST
Mailing Address - Street 2:B1
Mailing Address - City:HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120-1800
Mailing Address - Country:US
Mailing Address - Phone:412-464-4781
Mailing Address - Fax:412-464-1531
Practice Address - Street 1:1705 MAPLE ST
Practice Address - Street 2:B1
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-1800
Practice Address - Country:US
Practice Address - Phone:412-464-4781
Practice Address - Fax:412-464-1531
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002371101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional