Provider Demographics
NPI:1801177142
Name:SPERLICH, MICHELLE IRENE (MA, CPM)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:IRENE
Last Name:SPERLICH
Suffix:
Gender:F
Credentials:MA, CPM
Other - Prefix:
Other - First Name:MICKEY
Other - Middle Name:
Other - Last Name:SPERLICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:816 MINER ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3120
Mailing Address - Country:US
Mailing Address - Phone:734-994-0971
Mailing Address - Fax:
Practice Address - Street 1:13101 ALLEN RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2216
Practice Address - Country:US
Practice Address - Phone:734-785-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program