Provider Demographics
NPI:1750546792
Name:LOUISELLE, MICHELE RENEE (DOM, MSOM, DIPL OM,)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:RENEE
Last Name:LOUISELLE
Suffix:
Gender:F
Credentials:DOM, MSOM, DIPL OM,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 NATURES WAY
Mailing Address - Street 2:#28
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-3100
Mailing Address - Country:US
Mailing Address - Phone:214-412-8168
Mailing Address - Fax:
Practice Address - Street 1:8110 NATURES WAY
Practice Address - Street 2:#28
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-3100
Practice Address - Country:US
Practice Address - Phone:214-412-8168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM971171100000X
TXAC01133171100000X
FLAP2629171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist