Provider Demographics
NPI:1922632306
Name:STRANDELL, MICHAELA KATHRYN
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:KATHRYN
Last Name:STRANDELL
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 1:2525 18TH ST APT 559
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-6439
Mailing Address - Country:US
Mailing Address - Phone:920-342-9004
Mailing Address - Fax:
Practice Address - Street 1:2525 18TH ST APT 559
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-6439
Practice Address - Country:US
Practice Address - Phone:920-342-9004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst