Provider Demographics
NPI:1356083307
Name:NED, MICHELLE MARIE (DBH)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MARIE
Last Name:NED
Suffix:
Gender:F
Credentials:DBH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11555 SOUTHFORK AVENUE
Mailing Address - Street 2:APARTMENT 3095
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816
Mailing Address - Country:US
Mailing Address - Phone:337-854-5071
Mailing Address - Fax:337-474-0623
Practice Address - Street 1:11555 SOUTHFORK AVENUE
Practice Address - Street 2:APARTMENT 3095
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816
Practice Address - Country:US
Practice Address - Phone:337-854-5071
Practice Address - Fax:337-474-0623
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA171400000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171400000XOther Service ProvidersHealth & Wellness Coach