Provider Demographics
NPI:1902405889
Name:MICHELLE MCNALLY PSYD PLLC
Entity Type:Organization
Organization Name:MICHELLE MCNALLY PSYD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNALLY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:561-621-3137
Mailing Address - Street 1:6945 HALTON PARK LN
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2170
Mailing Address - Country:US
Mailing Address - Phone:561-621-3137
Mailing Address - Fax:561-228-5359
Practice Address - Street 1:6945 HALTON PARK LN
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-2170
Practice Address - Country:US
Practice Address - Phone:561-621-3137
Practice Address - Fax:561-228-5359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty