Provider Demographics
NPI:1457606709
Name:PAINTER, MICHELLE (BS OT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:PAINTER
Suffix:
Gender:F
Credentials:BS OT
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:3405 MORNING DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2135
Mailing Address - Country:US
Mailing Address - Phone:210-445-3414
Mailing Address - Fax:210-826-7887
Practice Address - Street 1:14207 HIGGINS RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-1252
Practice Address - Country:US
Practice Address - Phone:210-826-4492
Practice Address - Fax:210-826-7887
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX107987225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist