Provider Demographics
NPI:1952320947
Name:MICHELL LYN ARNOW PHD PA
Entity Type:Organization
Organization Name:MICHELL LYN ARNOW PHD PA
Other - Org Name:MICHELL LYN ARNOW PHDPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELL
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:ARNOW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:407-351-1055
Mailing Address - Street 1:PO BOX 690881
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-0881
Mailing Address - Country:US
Mailing Address - Phone:407-351-1055
Mailing Address - Fax:407-351-1185
Practice Address - Street 1:5007 GATEWAY AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821
Practice Address - Country:US
Practice Address - Phone:407-351-1055
Practice Address - Fax:407-351-1185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6338103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E5339Medicare ID - Type Unspecified